Developmental dsyplasia of the hip or DDH

Developmental dsyplasia of the hip or DDH is a problem with a dislocation of the hip joint develops. The condition is usually present from birth or young children.

Epidemiology
DDH occurs in about 1 of 100 births. It is more common in the left hip. In about 2 in 10 cases, DDH affects both hips.

Causes
The cause is unknown,but there are factors that are known to contribute to the chance of baby being born with DDH. These include:

  1. Gender
    being female (8 in 10 cases of DDH are female)
  2. Family history
    ten times more likely for a child to have DDH, if there is a parent, brother or sister with DDH
  3. Pregnancy condition
    low levels of amniotic fluid in the womb during pregnancy can increase a baby’s risk of DDH
  4. Breech delivery
    feet down position in the uterus, this can put the legs in a position which increase the risk of DDH
  5. Race
    DDH is more common in Native American children

Symptoms and Signs
No symptoms in a newborn baby with DDH. Soon after, birth most babies are examined by a hospital doctor. The doctor routinely screen all newborns and infants for hip dysplasia. One of the method to identifie the condition is a physical exam of the hips,which involves applying pressure while moving the hips. The doctor listens for any click, clunks, or pops.

The signs of hip problems are :

  1. The skin folds between the legs and the body may not be equal on both sides.
  2. The femur may look shorter on one side.

Ultrasound and an X-Ray of the hip may help and confirm this problem. In children over 4-6 months,an X-Ray is more helpful.

Treatment

The goal of treatment is to relocate the head of the femur into the acetabulum.

  1. Pavlik harness
    ¤to hold the hips in the correct position
    ¤first treatment in children under six months old
  2. Closed reduction and hip spica
    ¤used in children over six months nf age
    ¤ or if the pavlik harness is not effective
  3. Open reduction
    ¤used if child is much older when DDH is diagnoses
    ¤the above option fail
  4. Other types of surgery
    ¤If DDH has not resolved by 18 months

Prognosis
It can almost always be treated successfully with a positioning device (bracing),if DDH is identified in the first few months of life

Complication

  1. Bracing may cause skin irritation
  2. Differences in the lengths of the legs may persist despite appropriate treatment
  3. Untreated of hip dsyplasia will lead to arthritis and deterioration of the hip,which can be severely debilitating

(dr. rendra)

Source: DEVELOPMENTAL DYSPLASIA OF THE HIP @ HealthyCase
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