Paediatric Surgery

Paediactric hip disorders

There are a number of conditions children may experience as they develop and grow. In some cases, surgery can be effective at addressing the cause of disease.

A few common conditions include:

Developmental dysplasia of the hip (DDH)

This is when the hip joint doesn't develop properly, leading to instability and a greater risk of dislocation. It is most commonly seen in infants and young children.

If untreated, DDH can cause pain and discomfort, and later in life, increase the risk of developing arthritis. If you or a clinician has detected DDH, the good news is that treatment can help prevent long-term complications and significantly improve outcomes.

The type of surgical treatment for DDH depends on the age of the patient, the severity of the condition, and the specific anatomy of the hip joint. Some common surgical treatments for DDH include:

Closed reduction

Typically performed in infants ages 6 months and under. This is when the hip joint is manipulated into the correct position. This is considered a surgical intervention, and it is done under anaesthetic, however no surgical incision is made.

Open reduction

If surgery was required as an infant but never took place, this procedure may be used in older infants or children. Similarly to a closed reduction, the hip joint is moved back into its correct position but this is done surgically. Pins and screws will be used to hold the hip in position.

Osteotomy: In cases where the bones of the hip joint have not developed properly, an osteotomy may be necessary. This involves cutting and repositioning the bones to improve the fit of the joint.

Total hip replacement: In cases of severe DDH that have caused significant damage to the joint, a total hip replacement may be necessary. This involves removing the damaged joint and replacing it with an artificial joint.

Legg-Calvé-Perthes (Perthes) disease

When the bone at the hip joint becomes soft and breaks down due to reduced blood supply to the femoral head (the ball of the hip joint). This is typically observed in children between the ages of 4 to 10.

If surgery is required, Mr Bajaj may perform one of the following procedures:

Osteotomy

Cutting & reshaping the bone to optimise the alignment and improve function of the hip joint.

Hip arthroscopy

A minimally invasive surgery used to remove damaged or diseased tissue from the hip joint.

Joint replacement

In severe cases of Perthes disease, joint replacement surgery may be required. This would involve removing the damaged joint and replacing it with an artificial one.

Slipped capital femoral epiphysis (SCFE)

When the upper end of the thigh bone (femur) slips off the hip joint, resulting in pain and a reduced range of motion. It typically affects children aged 8 to 16.

Surgery may involve:

Pinning

The most common surgical treatment for SCFE involves inserting metal pins into the femoral head and neck to improve the structural integrity of the section of the point that makes up the hip joint. This would help prevent it from slipping further.

Open reduction and internal fixation (ORIF)

Involves making an incision in the hip area to access the hip joint, then the surgeon will realign the femoral head with the neck. They will then insert screws or pins to hold the bone in place so it doesn’t continue to move while it heals.

Osteotomy

As mentioned above, this involves cutting & reshaping the bone to optimise the alignment and improve function of the hip joint.

Mr Sunil Bajaj
Orthopaedic surgeon
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Other treatments

Read more about other conditions Mr Bajaj treats.