Hip Injuries, Age 11 and Younger

Topic Overview

A hip injury can be hard to deal with, both for the child who has the injury and for the parent or caregiver. A child who has a hip injury may feel pain in the hip, groin, thigh, or knee. A child in pain may limp or be unable or unwilling to stand, walk, or move the injured hip. A baby in pain may cry, be fussy, and have other signs of pain.

To better understand hip injuries, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttocks, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip injuries

A sudden (acute) injury may occur from a fall on a hip, a direct blow to a hip or knee, or abnormal twisting or bending of the leg. Acute injuries include:

Muscle strain in the hip, groin, or buttock.
Bruising (contusion) of the hip muscles (hip pointer). Deep muscle bruising may occur with other injuries to the hip. Tenderness and muscle spasm may also be present.
Dislocated hip , hip fracture, or pelvic fracture. Dislocations and fractures of the hips and pelvis are not often seen in children unless a severe injury (such as a car accident) has occurred.
Avulsion fracture . This occurs when a muscle forcibly tears away from a bone and breaks a piece of bone.

Treatment for a hip injury depends on the location, type and severity of the injury as well as the child's age, general health, and activity level. Treatment may include first aid measures; application of a brace, cast, harness, or traction; physical therapy; medicines; or surgery.

Use the Check Your Symptoms section to decide if and when your child should see a doctor.

Check Your Symptoms

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Home Treatment

Home treatment may help relieve your child's hip pain, swelling, and stiffness. If your child will cooperate, use the following tips. If your child becomes upset or will not cooperate, do not force your child.

Rest. Have your child rest and protect the sore hip. Have your child stop, change, or take a break from any activity that may be causing pain or soreness.
Ice will help your child's pain and swelling. Put ice or cold packs on the sore area immediately. Put ice on for 20 minutes out of every hour and do this 4 or more times in the first 1 to 2 days. If your child is cooperative, use the ice often. If your child is not cooperative, use the ice as much as you can without struggling with your child. Wrap the ice in a wet towel. Do not put the ice right on the skin. Take the ice off if your child falls asleep.
Place your child on the uninjured side for sleep.
Gently massage or rub your child's hip to relieve pain and encourage blood flow.
For the first 1 to 2 days after an injury, do not let your child do things that may increase swelling, such as taking hot showers, using hot tubs, or hot packs.
After 2 to 3 days, if the swelling is gone, heat can be put on the hip. Your child can carefully begin normal activities. Moist heat with a hot water bottle, warm towel, or a heating pad set on low may feel good to your child.

**Medicine you can buy without a prescription**
Try a nonprescription medicine to help treat your child's fever or pain:
Acetaminophen, such as Tylenol Ibuprofen, such as Motrin or Advil Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

**Safety tips**
Be sure to follow these safety tips when you use a nonprescription medicine:
Carefully read and follow all labels on the medicine bottle and box. Give, but do not exceed, the maximum recommended doses. Do not give your child a medicine if he or she has had an allergic reaction to it in the past. Do not give aspirin to anyone younger than age 20 unless directed to do so by your child's doctor. Do not give naproxen sodium (such as Aleve) to children younger than age 12 unless your child's doctor tells you to.

Cast care tips

If your child has a cast, see cast care tips.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your child's symptoms if any of the following occur during home treatment:

Pain or swelling develops.
Signs of infection develop.
Numbness, tingling, or weakness develops.
Pale, white, blue, or cold skin develops.
Symptoms do not get better with home treatment.
Symptoms become more severe or more frequent.

Prevention

The following tips may prevent the chance of hip injuries.

Always be gentle with your child. Do not grab your child by his or her legs.
Be aware of your child's chance of falling, and take steps to prevent falls.
Never leave a baby unattended in high places, such as on a tabletop, in a crib with the sides down, or even on a bed or sofa.
Do not leave a baby unattended in any infant seat or "sitting" toy, such as a swing, walker, saucer, or jumper. Use all the safety straps provided.

Establish good safety habits early so that your child will continue them when he or she is older.

Place children in an approved child car seat when riding in a motor vehicle. Follow the manufacturer's directions for installing and securing the seat.
Have older children wear seat belts every time they are in a motor vehicle. Set a good example by always using your seat belt when traveling in a motor vehicle.
Have your child wear protective gear when playing contact sports such as football or hockey.

Injuries may occasionally be a sign of abuse. You may be able to prevent further abuse by reporting it and seeking help.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your child's condition by being prepared to answer the following questions:

What are your child's main symptoms? How long has your child had symptoms?
How and when did an injury occur?
Has your child had any injuries in the past to the same area? Does your child have any continuing problems because of the previous injury?
Does your child limp or complain about pain when he or she walks? Where is the pain felt? How far can your child walk without discomfort? Does the pain get better or worse as he or she continues to walk?
What activities make your child's symptoms better or worse?
What activities is your child involved with? Has your child recently started a new activity?
What home treatment measures have you tried? Did they help?
What prescription or nonprescription medicines has the child taken? Did they help?
Does your child have any health risks that may increase the seriousness of his or her hip symptoms?

Related Information

Credits

Author	Jan Nissl, RN, BS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Tracy Landauer
Primary Medical Reviewer	Steven L. Schneider, MD - Family Medicine
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Adam Husney, MD - Family Medicine
Specialist Medical Reviewer	H. Michael O'Connor, MD - Emergency Medicine
Last Updated	September 15, 2008

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