Hip dysplasia in infants: screening and early treatment safeguard motor development
If action is taken before the age of two months, severity no longer affects the age at which the child begins to walk: even in the most complex cases, motor development is comparable, as shown by research published in the Journal of Children's Orthopaedics
Developmental dysplasia of the hip is one of the most frequent orthopaedic diseases in newborns. In the most severe forms, treatment involves closed reduction of the dislocated joint and a period of immobilisation with a plaster cast and/or brace. A phase that often causes apprehension among parents, who fear that the motor limitations may delay the onset of walking.
The search
A new Italian study published in the Journal of Children's Orthopaedics provides clarity. The research, led by myself, involved 52 children with hip dysplasia types D, III and IV, using both a retrospective study conducted between 2015 and 2020 and a prospective study conducted between 2020 and 2021. All young patients were treated with closed reduction and immobilisation using a cast and/or brace.
The results
The results are reassuring: the average age of gait acquisition was around 14.6 months, perfectly in line with the physiological window indicated by the WHO (9-18 months). The decisive factor, the authors explain, is the age at which treatment begins. If action is taken before the age of two months, the severity of the dysplasia no longer influences the age at which the child begins to walk: even in the most complex cases, motor development is comparable.
The message to families is simple but fundamental: early diagnosis allows excellent results, even in the most severe forms. Early treatment reduces the impact of the disease and ensures completely normal motor development.
The Oms indications
The research also addresses a very practical issue: the WHO guidelines recommend avoiding fixed positions for more than an hour during the first months of life and ensuring at least 30 minutes a day of tummy time, the time on the stomach that is essential for muscle development. Recommendations that are difficult to reconcile with a brace or full-time cast treatment, especially in severe cases. Optimising the treatment and starting it within the first two months of life makes it possible to shorten it, reducing immobilisation time and increasing tummy time. The study also showed that any small initial delays in motor milestones recover quickly and leave no long-term consequences.
