Developmental Hip Dysplasia
Developmental Dysplasia of the Hip (DDH) refers to an abnormal formation of the hip joint of a child where the thighbone is not held firmly in the socket, and the ligaments may be loose or stretched. In some children, the femur is loose in the socket at birth; in others, the bone is completely out of the socket. In some children, the looseness worsens as the child grows and becomes more active.
Children are screened for DDH at birth and at well baby checkups. When detected at birth, DDH can usually be corrected; however, if the hip is not dislocated at birth, DDH can go unnoticed until the child starts to walk, making treatment more complicated.
If DDH goes untreated, it can lead to pain and osteoarthritis in early adulthood. It can lead to a difference in leg length and decreased agility.
DDH is treated based on the child’s age. Newborns are placed in a Pavlik harness for up to two months to keep the thighbone in the socket. This helps tighten the ligaments around the hip joint and helps the hip socket form normally.
For babies one to six months old, the thighbone is repositioned in the socket using another harness. If this method is unsuccessful, the baby may need to undergo anesthesia so that a doctor can move the thighbone into proper position. A body cast will then be used to keep everything in place.
For infants six months to two years old, the child is placed under anesthesia so that the thighbone can be moved into place. Open surgery may be necessary.
Children over the age of two may have severe deformities that require open surgery to realign the hip, followed by a body cast to maintain the proper positioning.
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