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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 buttock, 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.
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 tendon or ligament forcibly tears away from a bone and breaks off 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.
Check your child's symptoms to decide if and when your child should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Major trauma is any event that can cause very serious injury, such as:
- A fall from more than 10 ft (3.1 m)[more than 5 ft (1.5 m) for children under 2 years and adults over 65].
- A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
- Any event that causes severe bleeding that you cannot control.
- Any event forceful enough to badly break a large bone (like an arm bone or leg bone).
With severe bleeding, any of these may be true:
- Blood is pumping from the wound.
- The bleeding does not stop or slow down with pressure.
- Blood is quickly soaking through bandage after bandage.
With moderate bleeding, any of these may be true:
- The bleeding slows or stops with pressure but starts again if you remove the pressure.
- The blood may soak through a few bandages, but it is not fast or out of control.
With mild bleeding, any of these may be true:
- The bleeding stops on its own or with pressure.
- The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Pain in children 3 years and older
- Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
- Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
- Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.
When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.
There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Babies and young children often have several symptoms of shock. These include:
- Passing out (losing consciousness).
- Being very sleepy or hard to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused. The child may not know where he or she is.
Symptoms of infection may include:
- Increased pain, swelling, warmth, or redness in or around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:
- Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
- Steroid medicines, which are used to treat a variety of conditions.
- Medicines taken after organ transplant.
- Chemotherapy and radiation therapy for cancer.
- Not having a spleen.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.
Sometimes people don't want to call 911 . They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
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.
- 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 using 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 or warm towel may feel good to your child.
Try a nonprescription medicine to help treat your child's fever or pain:
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.
Be sure to follow these safety tips when you use a nonprescription medicine:
Cast care tips
If your child has a cast, see cast care tips.
Symptoms to watch for during home treatment
Call your child's doctor 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.
- Your child does not want to bear weight on the side of the hip injury.
- Symptoms do not get better with home treatment.
- Symptoms become more severe or more frequent.
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 doctor 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?
Current as of: June 26, 2019
Author: Healthwise Staff
Medical Review: William H. Blahd Jr. MD, FACEP - Emergency Medicine
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine