Amber and Nicole knew their daughter, Cameron, was in a breach position and likely to be delivered via c-section.

What they didn’t know was that something more concerning was going on with Cameron; or that the news would break while Amber was still in the operating room.

“If you took a baby doll and folded it in half, where the head is at her feet, that's literally how she came out,” Amber said, describing Cameron’s unique delivery.

Members of the neonatal intensive care unit (NICU) managed to get Cameron’s feet down, but it wasn’t long before they whisked her off for further assessment.

And while the family was soon reunited in the post-delivery suite, it was only six weeks later that Cameron’s treatment journey began in earnest, ultimately leading to the expert care of Wudbhav N. Sankar, MD, and the Hip Disorders Program at Children’s Hospital of Philadelphia (CHOP).

Hip dysplasia diagnosis

In January, about a month after she was born, Cameron got an ultrasound and then, a diagnosis – bilateral hip dislocations, a severe form of developmental dysplasia of the hips (DDH). 

DDH is more common in kids that are breach in utero. It can range in severity from shallowness in the hip socket to full dislocation of the joint. 

Based in New Jersey, the family took Cameron to a local orthopedic surgeon, who was stunned to find one of the most severe cases he'd ever seen. 

A Pavlik harness, a non-surgical treatment intended to guide the hip into place over time, was tried first.

After just two weeks though, the harness was abandoned, kickstarting a long and winding pre-CHOP treatment journey for Cameron.

A closed reduction in the operating room was next, the doctor surgically releasing Cameron’s adductor tendon and guiding her hips into place, then placing her in a spica (body) cast.

Usually worn for three months, Cameron kept her first spica cast for less than 24 hours because her hips had re-dislocated in the cast.

A more complex procedure known as an open reduction, in which an incision is made, and the joint is opened to clear tissue and directly put the ball into the hip socket, followed.

While the doctor was able to get one hip to “reduce,” the second was simply beyond what he could manage.

CHOP open reduction revision and femoral shortening

In July, Cameron, Amber and Nicole had their first visit with Dr. Sankar at CHOP.

“We saw him on a Friday,” Amber said. “He said, ‘Let's get her in next week.’ He didn't want scar tissue to form and make it difficult to get in and work on it.”

After another X-ray and discussions of potential treatment plans, it was decided that Dr. Sankar would attempt a re-do open reduction and femoral shortening osteotomy.

According to Dr. Sankar, if both hips failed Cameron would have a “waddling limp,” but still be able to walk. If only one hip failed, the limp would be severe, and the legs would be different lengths.

“We either wanted both hips to fail or both to succeed,” Amber recalled.

A week later, following an X-ray to confirm her left hip remained in place, Cameron underwent the revision open reduction and femoral shortening osteotomy on her right hip at CHOP’s Middleman Family Pavilion, King of Prussia Campus.

“Dr. Sankar shaved a couple millimeters off the femur to get it to fit into the socket,” Amber recalled. “And then he held it in place with screws and a plate.”

Casting and surgical hardware removal

Again, Cameron was placed in a spica cast following the procedure.

Her legs rigidly splayed, not quite sitting and not quite standing, with limited diaper access and few options to lay comfortably, the cast may have been the most difficult part of Cameron’s journey.

A beanbag chair helped her lay back. The spica table Amber’s cousin built allowed Cameron to sit and eat more easily. And the team at CHOP did everything they could to help guide the family through this difficult time.

“If I can handle her for 12 weeks in this cast, whatever she throws at me now, it's nothing,” Amber said.

Fortunately, Cameron’s hips remained in place and healed well over those weeks. 

And though Dr. Sankar made clear that there was still work to do, for the moment, they were all happy to take the win.

Exactly one month later, with Cameron under anesthesia, Dr. Sankar pulled the pins from her left hip and placed her in a new spica cast.

Thankfully, Cameron would only have to keep it for about a month before transitioning to a brace.

Over time, Cameron wore the brace less too, from nighttime to naps to no brace at all.

Walking into the future

In late April, the family returned to CHOP to have the remaining plates and screws removed from Cameron’s right hip.

And while Cameron had to “start at square one,” her work with a physical therapist helped her quickly re-learn how to crawl.

And at 15 months old, Cameron started to walk.

Eventually, Dr. Sankar expects Cameron to run and play, just like other children.

In time, there is the possibility of another surgery if the socket doesn’t continue to deepen on its own. 

But, at least for now, the family aren’t worried about Cameron’s future because, as Amber said, “she’s getting the best care, and we know we're in good hands.”