Child Health Library

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Hip Injuries, Age 11 and Younger

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's 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 doesn't 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.

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. The muscles may spasm and feel tender.
  • A dislocated hip, a hip fracture, or a pelvic fracture. Dislocations and fractures of the hips and pelvis aren't often seen in children unless a severe injury (such as a car crash) 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 may include first aid and using a brace, cast, harness, or traction. It may also include physical therapy and medicines. In some cases, surgery is needed. Treatment for a hip injury depends on:

  • The location and type of injury, and how bad it is.
  • The child's age, general health, and activity level.

Check Your Symptoms

Has your child had a hip injury?
Yes
Hip injury
No
Hip injury
How old are you?
Less than 5 years
Less than 5 years
5 to 11 years
5 to 11 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female

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.
Has your child had hip surgery in the past month?
If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.
Yes
Hip surgery in past month
No
Hip surgery in past month
Has it been more than a month since the hip injury?
Yes
Hip injury over a month ago
No
Hip injury over a month ago
Has your child had a major trauma in the past 2 to 3 hours?
Yes
Major trauma in past 2 to 3 hours
No
Major trauma in past 2 to 3 hours
Does your child have severe bleeding that has not slowed down with direct pressure?
Yes
Severe bleeding
No
Severe bleeding
Does your child have symptoms of shock?
Yes
Signs of shock
No
Signs of shock
Is your child having trouble moving the hip or leg?
Yes
Difficulty moving hip or leg
No
Difficulty moving hip or leg
Can your child move the hip and leg at all?
Yes
Able to move hip and leg
No
Unable to move hip and leg
Has your child had trouble moving the hip for more than 2 days?
Yes
Difficulty moving hip for more than 2 days
No
Difficulty moving hip for more than 2 days
Does your child seem to have any hip pain?
Yes
Appears to have hip pain
No
Appears to have hip pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
5 to 10: Moderate to severe pain
Moderate to severe pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Does your child seem to have any hip pain?
Yes
Appears to have hip pain
No
Appears to have hip pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Has your child had pain for more than 2 days?
Yes
Pain for more than 2 days
No
Pain for more than 2 days
Is the leg or foot blue, very pale, or cold and different from the other one?
If the area is in a cast, splint, or brace, follow the instructions you got about how to loosen it.
Yes
Leg or foot blue, very pale, or cold and different from other leg or foot
No
Leg or foot blue, very pale, or cold and different from other leg or foot
Is there any swelling or bruising?
Yes
Swelling or bruising
No
Swelling or bruising
Did you have swelling or bruising within 30 minutes of the injury?
Yes
Swelling or bruising within 30 minutes of injury
No
Swelling or bruising within 30 minutes of injury
Has swelling lasted for more than 2 days?
Yes
Swelling for more than 2 days
No
Swelling for more than 2 days
Has your child had numbness, tingling, or weakness in the hip that has lasted more than an hour?
Weakness means that the child cannot use the leg or hip normally no matter how hard he or she tries. Pain or swelling may make it hard to move, but that is not the same as weakness.
Yes
Numbness for more than 1 hour
No
Numbness for more than 1 hour
Do you suspect that the injury may have been caused by abuse?
This is a standard question that we ask in certain topics. It may not apply to you. But asking it of everyone helps us to get people the help they need.
Yes
Injury may have been caused by abuse
No
Injury may have been caused by abuse
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think the problem may be causing a fever?
Some bone and joint problems can cause a fever.
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Does your child have diabetes, a weakened immune system, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, or surgical hardware in affected area
No
Diabetes, immune problems, or surgical hardware in affected area
Has your child had symptoms for more than a week?
Yes
Symptoms for more than a week
No
Symptoms for more than a week

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, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or 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.
Hip Injuries, Age 12 and Older
Hip Problems, Age 11 and Younger
Postoperative Problems

Self-Care

Try the following tips to help relieve your child's hip pain, swelling, and stiffness. If your child becomes upset or won't cooperate, don't force your child.

  • Rest.

    Have your child rest and protect the injured or sore hip. Have your child stop, change, or take a break from any activity that may be causing pain or soreness.

  • For sleep, put your child on the side that isn't injured.
  • Avoid things that might increase swelling.

    For the first 48 hours after an injury, don't let your child do things that might increase swelling. These things include taking hot showers, using hot tubs, and using hot packs.

  • Apply heat.

    After 48 to 72 hours, if swelling is gone, you can put heat on your child's hip. Moist heat with a hot water bottle or warm towel may feel good to your child.

  • Resume normal activities.

    After 48 to 72 hours, if swelling is gone, your child can carefully do their normal activities.

  • Rub your child's hip.

    Gently massage or rub your child's hip to relieve pain and encourage blood flow. Don't massage the injured area if it causes pain.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • New pain or swelling.
  • New signs of infection, such as redness, warmth, or a fever.
  • New numbness, tingling, or weakness.
  • New pale, white, blue, or cold skin.
  • Trouble bearing weight on the hip.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

Credits

Current as of: March 9, 2022

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