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Developmental Dysplasia

Developmental hip dysplasia (DDH) is a paediatric hip disorder ranging from minor radiological changes to frank dislocation. If left untreated it can result in a marked limp with leg length discrepancy and early onset arthritis requiring a total hip replacement in teenage years.

It is asymptomatic so can be difficult to detect. Examination of a baby’s hips at birth or an ultrasound of high risk babies is the commonest way to diagnose DDH. Risk factors for DDH include being female, first born, high birth weight, breech position and family history.

If diagnosed at, or soon after birth, treatment initially involves being placed in a Pavlic harness. If the hips have not improved on repeat ultrasound, or the diagnosis of DDH is made late, an operation to examine the hip under general anaesthetic with radio-opaque dye inside the hip (arthrogram) is indicated. A hip spica is then applied with the hip in a position of maximum stability. This is left on for up to 3 months.

If the hip fails to respond to this treatment, a more involved operation to open up the hip and directly put it back into the socket is required – an open reduction. This may be combined with operations to change the shape of the thigh bone (femoral osteotomy) or socket (acetabular osteotomy).

Children with DDH are followed up at intervals until they are skeletally mature at around 16.

 

Developmental dysplasia of the hip
 

You and Your child in a Hip Spica
 

More information about developmental dysplasia
 

Avoiding an unsanitary Hip Spica