Livia had a normal pregnancy and a normal head-down vaginal birth. Livia’s only risk factors for DDH were first-born and female.
Everything was normal in the nursery, however, at her eight-week check-up (in 2000) her pediatrician noticed a “click” in her left hip. This was a Friday. By Tuesday, we had an appointment for an ultrasound with an orthopedic doctor. He told us that her hip was “dislocatable with pressure”, meaning that the hip was in but when you pressed it the right way it would pop out. He recommended a Pavlik harness and assured us that this was a very correctable problem and would like to see her in four weeks. After this appointment I did a web search and found more on hip dysplasia with German shepherds than hip dysplasia with humans. Somehow I stumbled onto the e-group website “Hipbabies” that had been started only four days before. At that time I became the third or fourth member. What a lifesaver!
Four weeks later we returned (it was in 2000 and Livia was now 12 weeks old). She had an x-ray done which showed that the hip was completely out of the socket – the Pavlik hadn’t improved anything. In fact, the hip was worse. This doctor then referred us to a pediatric orthopedic surgeon at the local Children’s Hospital. This was a Tuesday and we had an appointment with Dr. W at the hospital by Friday.
I felt everything was moving too fast, but as I found out later there is a certain time frame where the success of correcting DDH is the highest. Dr. W confirmed that the hip was out of socket and recommended either a closed or open reduction. These are types of surgeries and both involve spica casts. We were scheduled for surgery less than a week later. He explained that he didn’t know which one Livia would need until she was actually under anethesia. When she was completely relaxed he would attempt to place the hip back in the socket without making any incisions. If the hip stayed in then he would just apply the cast (closed reduction). If the hip did not stay in then he would have to make an incision into the hip (open reduction).
Because of scar tissue that had already filled the hip socket, the hip would not stay. Livia had to have the open reduction. An incision was made in her inner thigh and the scar tissue was scraped out. After that, the hip bone fit nicely in the socket and a spica cast was applied.
The spica went from her rib cage to her feet; just her toes were sticking out. Livia had to stay in the hosptial overnight but was doing so well the next day that we were able to go home early. She had the cast on for seven weeks and then we went back to the hospital to have the cast removed and see if the hip was stable (2000). The hip looked good and she didn’t have to have the spica anymore but was moved to a Hewson brace. This was to be on for 24 hours a day for the next six weeks. We were able to take it off for diaper changes and one bath a week. After six weeks (2000) the hip still looked good and the Hewson brace was decreased to 12 hours a day. At the end of the year, 2000 (Livia was 10 months old) the x-ray looked great and we were able to discontinue any sort of brace! Livia is now in follow-up and has to return in April, 2001 for another x-ray as the hip could slip back out. After that, she will continue to have follow-up every year until she is 16 years old.
After an x-ray in 2001, Livia’s hips were pronounced “perfect” by her doctor. She is now on yearly x-ray’s and exams until age 16. In June 2001, a baby brother arrived and after several thorough checks and an ultrasound, his hips appear to be normal.
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