A paediatrician at the University College
London, Dr. Alastair Sutcliffe, caused a stir
earlier in the week when he suggested that
based on research findings, carrying babies
with the legs splayed around the waist could
lead to hip dislocation.
Nigeria was singled out mainly because of the
way we strap babies to the back, with the legs
wrapped round mother’s waist.
The study, published in the Archives of
Disease in Childhood , warns that while many
parents insist that the technique is soothing
and aids their child’s sleep, “researchers
underlined that links have been observed to
osteoarthritis and hip replacement in middle
age.”
In addition, a paediatric orthopaedic surgeon,
Mr. Nicholas Clarke, says this traditional way
of carrying infants is a risk factor for
developmental dysplasia of the hip.
Researchers say it is easier for an infant’s hip
to become misaligned or dislocate than an
adult hip because an infant’s hip socket is
mostly soft, pliable, cartilage; whereas an
adult’s hip socket is hard bone.
The physicians advise, “In order to allow for
healthy hip development, (babies) legs should
be able to bend up and out at the hips. This
position allows for natural development of the
hip joints. The babies’ legs should not be
tightly wrapped in extension and pressed
together.”
What is hip dislocation?
The online portal, orthoinfo.aaos.org, says a
hip dislocation occurs when the head of the
thigh bone (femur) slips out of its socket in
the hip bone (pelvis).
It warns, “In approximately 90 per cent of
patients, the thigh bone is pushed out of its
socket in a backwards direction, leaving the
hip in a fixed position, bent and twisted in
toward the middle of the body.”
Physicians say the thigh bone can also slip
out of its socket in a forward direction,
making the hip to bend slightly, in which case
the leg will twist out and away from the
middle of the body.
Experts warn that hip dislocation is very
painful, and that patients will be unable to
move the leg. Worse still, they say, if it is
attended by nerve damage, the victim may not
have any feeling in the foot or ankle area for
some time to come.
Causes
Orthopaedic surgeons say among adults,
direct trauma, such as motor vehicle
accidents, is the most common cause of hip
dislocations; saying that is why wearing a
seatbelt whenever you are in a moving vehicle
is imperative because it can greatly reduce
your risk.
Again, they say, falls from a height (such as a
fall from a ladder) or industrial accidents can
also generate enough force to dislocate a hip.
Physicians say though a violent force is
usually required to dislocate an adult’s hip,
children may sustain a hip dislocation
following relatively minor trauma.
At an earlier encounter, bone specialist/Group
Medical Director, Lagoon Hospitals, Dr. Kunle
Onakoya, says with hip dislocations, there are
often other injuries, including fractures in the
pelvis and legs, back injuries, or head injuries.
He warns that it takes time — sometimes two
to three months — for the hip to heal after a
dislocation.
He adds that depending on the extent of the
injury, leg deformity may also occur. “This
depends on the nature and extent of
penetration into the pelvis. If it is severe, the
leg may be shortened, abducted or adducted,
and internally or externally rotated,” he
explains.
While physicians say hip dislocation may not
necessarily lead to death, they warn that
“associated injuries of the pelvis, head, or
thorax may lead to death,” as these factors
are likely to complicate the injury.
Worse still, physicians say, recurrent
dislocation may occur or become common
because of the damage done to supporting
ligaments.
Symptoms
Experts say in an accident victim or a
pedestrian hit by a vehicle, a traumatic hip
dislocation can cause:
• Severe hip pain, especially when the leg is
moved.
• The injured leg is shorter than the uninjured
leg.
• The injured leg lies in an abnormal position.
In most cases, the leg is bent at the hip,
turned inward and pulled toward the middle
of the body.
Physicians say it is absolutely necessary to
see the doctor immediately if you cannot
move your hip joint after a fall or other
traumatic injury; or if the affected hip is
painful, swollen, tender or deformed.
The American Academy of Orthopaedic
Surgeons contends that although the outlook
depends on many factors, the timing of
treatment is particularly important.
For example, it says, “One study showed that
88 per cent of patients had good or excellent
results if a dislocated hip was restored to its
normal position in its socket within six hours
after injury. After six hours, the risk of
permanent damage increased significantly,
and it was highest when treatment was
delayed for 24 hours or more.”
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