Developmental Dislocation of the Hip

Overview

Developmental dysplasia of the hip (DDH) is also referred as congenital hip dislocation or hip dysplasia. Developmental dysplasia of the hip is present at birth. The condition of dysplasia of the hip is generally found in babies or young children. This is a condition where the ball and socket joint of the hips do not fit properly. In developmental dysplasia of the hip, the socket of the hip is too shallow and the femoral head is placed tightly in the place so the hip joint is loose. In severe cases of dysplasia of the hip, the femur can come out of the socket causing dislocation. Dysplasia of the hip can affect one or both hips but it more commonly occurs in the left hip.

Without proper treatment for dysplasia of the hip it can lead to problems such:-
·         Development of a limp.
·         Pain in the hip.
·         Painful and stiff joints.

If dysplasia of the hip is diagnosis and treated at an early stage then most individual are able to develop normally and have a full range of movements in the hip.

Causes of developmental dislocation of the hip

The cause of dislocation of the hips is unknown. According to the research low levels of amniotic fluid in the womb during pregnancy can increase a child's risk of developmental dislocation of the hip. Following are some of the other causes of dislocation of hips:-

• Family history of the disorder.

• The risks are higher in first child.

• Large birth weight.

• The risks are higher in a female child.

• Breech position during pregnancy, in which the baby's bottom is down.

Symptoms of developmental dislocation of the hip

In many cases, there are no symptoms of dislocation of the hip but there are some common symptoms that may occur in a newborn which is followed below:-

• The leg affected with hip problem appears to turn out more.

• The child's lower back is rounded inward.

• Uneven skin folds of thigh or buttocks.

• Waddling.

• The movements are reduced on the side of the body affected with dislocation.

• Limping while walking.

• The affected leg with hip dislocation appears shorter.

Treatment of developmental dislocation of the hip

There are two treatments for dislocation of the hip
1.       Nonsurgical Treatment.
2.       Surgical Treatment.

The type of treatment depends on the age of the child. If dislocation of the hip is detected at birth it is usually corrected with the use of a harness or brace. In case if the dislocation of hip is not dislocated at the time of the birth or until the child begins walking the treatment is more complicated, with less predictable results.

Nonsurgical Treatment

• For treating newborns: - The newborns are placed in a Pavlik harness for 1 to 2 months to keep the thighbone in the socket. The Pavlik harness helps tighten the ligaments around the hip joint and promotes normal hip socket formation.

Surgical Treatment

• For treating child between 6 months to 2 years an open surgery is performed for proper positioning of the thighbone. In some cases, the thighbone is shortened so that it could properly fit into the socket.

• For treating a child older than 2 years an open surgery is performed to realign the hip. A Spica cast is usually applied to maintain the hip in the socket.

Treatment for developmental dislocation of the hip in India

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