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Developmental Dysplasia of Hip (DDH) in Children

Hip dysplasia is a ‘silent’ condition and a developmental deformation or misalignment of the hip joint in infants. The problem area can be the femoral head of the hip joint or the acetabulum of the hip joint, or both. Doctors call it as congenital hip dysplasia or developmental dysplasia of the hip.

Causes of Hip Dysplasia in Babies

  • Hip dysplasia occurs in about 0.5% of all births and common in 1st born girls.
  • It is common in the case of large fetus or a fetus in a breech position.
  • Hip dysplasia family history
  • Oligohydraminos which is a lack of intrauterine fluid
  • In-utero position of the baby like clubfoot and torticollis

Hip Dysplasia Causes and Symptoms

Signs and Symptoms of Hip Dysplasia

  • Hip Dysplasia can be bilateral or unilateral and range from barely detectable to severely malformed/dislocated.
  • In bilateral dysplasia, some indicators are asymmetric folds and inequality in leg-length.
  • In unilateral dysplasia, only one joint shows malformation, the other side may show resulting effects. In majority unilateral cases, usually the left hip is more affected than the right.
  • A false acetabulum often forms in the fully dislocated joint.
  • The acetabulum is too much deformed in actetabular dysplasia
  • Beukes familial hip dysplasia is very common among Afrikaners of the Beukes group.

Diagnosis of Hip Dysplasia

The physical examination of the children determines the condition of Hip Dysplasia. While performing special maneuvers of the hip joint, the doctor will feel ‘hip click’. The Barlow and Ortolani tests cause a hip that is out of position to “click” as it moves in and out of the proper position. The doctor then performs an ultrasound to assess the joint. The ultrasound shows the position and shape of the hip joint. If the ball is outside of the socket or and has poorly formed socket, then surgical treatment is needed.

Hip Dysplasia Surgery Cost

Treatment of Hip Dysplasia

The congenital hip dislocation treatment varies for each individual baby depending on the baby’s age. The goal is to properly position or reduce the hip joint. Once the reduction is acquired, the doctor holds the hip in the reduced position and allows the body to adapt to the new position. Hip Dysplasia surgery results are quite positive if the child is younger, because the capacity to adapt the hip and chance of full recovery is much better in such cases.

  1. If the child is up to 6 months, then the use of a special brace called a Pavlik harness is reduced. About 92% of newborns with hip dysplasia are treated in a Pavlik harness to recover fully.
  2. If the child is 6months – 1 year old, then under general anesthesia the surgeon will put the hip in proper position and later the child will be placed in spica cast which is similar to the Pavlik harness.
  3. If the child is over 1 yearold, then the hip joint is reduced and properly positioned with the surgery. After the surgery with the spica cast the child is able to hold the hip in proper position.

Success of Treatment

The success rate of the hip subluxation in infants depends on the child’s age and adequateness of the reduction. The younger the child better are the chances of early & complete recovery. Children with this persistent condition have a chance of getting pain and hip arthritis later in life. Hip osteotomy or hip replacement surgery may be needed later in life. The success of hip dysplasia treatment in India is 95-97%.

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