Save yourself from hip dislocation

By Solaade Ayo-Aderele 

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.”