Update on Matilda's Hip Dysplasia

We had another one of Matilda’s 6-month hip checkups this past week.  Her x-rays are showing no signs of improvement despite still wearing her brace every night.  Due to how severely shallow her socket is, the doctor is preparing us for another surgery followed by another 6-weeks in a spica cast (chest to ankles).  We’ll have another round of x-rays in 6 months, and then he’ll likely schedule the surgery for the following couple of months (so I’m guessing the surgery could be 7-10 months from now). 

 

I believe the doctor would perform a Dega or Pemberton osteotomy which would reposition the socket to make it deeper.  He would use a bone graft instead of pins, so I don’t think follow-up surgery to remove the hardware would be required (at least that’s how I understand it as of this point.)

 

Here’s a good explanation of the Dega osteotomy:

 

http://hipdysplasia.org/developmental-dysplasia-of-the-hip/child-treatment-methods/osteotomy/

 

Furthermore, her femoral head is still not ossifying which could be from a complication from the first surgery (AVN – basically where the blood flow to the ball was compromised when they shoved her dislocated leg into the socket).  This could lead to a deformation of the femoral bone/ head over the long term.

 

Here’s a good explanation of AVN in young children:

 

http://hipdysplasia.org/developmental-dysplasia-of-the-hip/problems-after-treatment/avascular-necrosis/

 

The good news is that her leg is still in the socket, she’s not complaining of any pain, and she’s really showing no signs of her hip dysplasia as far as walking/ running/ jumping/ etc.  She acts like a completely normal 2 year old!