Developmental Dysplasia of the Hip (DDH)

Developmental dysplasia of the hip (DDH) is a medical condition where the hip joint does not form properly, leading to instability and potential long-term damage. It is also known as hip dysplasia or congenital dislocation of the hip.

Causes and Risk Factors

The exact cause of DDH is unknown, but several risk factors have been identified:

• Family history: Individuals with a family history of DDH are more likely to develop the condition.
• Genetics: Certain genetic conditions, such as Down syndrome and Ehlers-Danlos syndrome, increase the risk of DDH.
• Breech presentation: Babies born in a breech position (feet or buttocks first) are at higher risk for DDH.
• Firstborn status: Firstborn babies are more likely to develop DDH due to the uterus being smaller and more compact.
• Cultural practices: Certain cultural practices, such as swaddling or wrapping a baby tightly, can increase the risk of DDH.

Symptoms and Diagnosis

Symptoms of DDH may include:

• Asymmetric skin folds on the thighs
• Difference in leg length
• Limited range of motion in the hip joint
• Clicking or clunking sound when moving the hip joint (Ortolani sign)
• Pain or stiffness in the hip joint

Diagnosis is typically made through a combination of:

• Physical examination: A healthcare provider will perform a physical exam to check for signs of DDH.
• Imaging tests: X-rays, ultrasound, or MRI scans may be used to confirm the diagnosis and assess the severity of the condition.

Treatment Options

Treatment for DDH depends on the age of the individual and the severity of the condition:

• Infants (0-6 months): The Pavlik harness is a common treatment option, which involves wearing a special brace to hold the hip joint in place.
• Children (6-18 months): Closed reduction or open reduction surgery may be necessary to realign the hip joint and stabilize it with pins or casts.
• Older children and adults: Treatment options may include physical therapy, pain management, and surgical procedures such as osteotomy or arthroplasty to repair or replace the damaged hip joint.

Complications and Prognosis

If left untreated, DDH can lead to:

• Chronic pain and stiffness
• Osteoarthritis
• Limited mobility and activity level
• Premature wear and tear on the hip joint

Early diagnosis and treatment can significantly improve outcomes and reduce the risk of long-term complications. With proper treatment, most individuals with DDH can lead active and normal lives.