Hip Dysplasia
Developmental Dysplasia of the Hip (DDH)
DDH can also be referred to as congenital dislocation of the hip, which is an umbrella term for numerous biomechanical hip joint abnormalities. Such abnormalities can include hip dislocation, increased susceptibility to hip subluxation, or inadequate hip joint development (see figure 1). DDH has an occurrence of 1:1000 live births; girls tend to be more commonly affected than boys; and left hip DDH more prevalent than right (although bilateral dislocations are not uncommon).
Risk Factors For DDH
Family history of DDH
Breech position during pregnancy
First born child
Female
Large birth weight
Signs & Symptoms
Uneven skinfolds in the buttock and thigh region
One leg is longer than the other
Leg may be turned outward
Reduced movement of affected leg
Clicking sound or clunking feeling with leg movement
Difficulty/delay with crawling or walking
Diagnosis
Your baby is screened for DDH on numerous occasions by pediatric healthcare providers and can usually be diagnosed within the first 2 years of life. If under 4 months old, ultrasound in conjunction with a physical examination (including an Ortolani and Barlow test) are the diagnostic tools used to determine whether your infant has DDH. In the case of a 4 month old or older, x-rays may be required, as the bones that comprise the hip joint have typically begun to develop by this stage.
Treatment & Prognosis
If DDH is detected in early infancy (younger than 6 months), a simple pavlick harness (see figure 2) can usually be worn in conjunction with physiotherapy stretches and exercises to successfully correct this condition. If detected after 6 months of age, it is more likely that surgery will be required and physiotherapy treatment to follow. The later DDH is detected the poorer the prognosis. Untreated DDH may lead to arthritis and deterioration of the hip, resulting in a severely incapacitating state.
If your baby is displaying any signs or symptoms of DDH please call Stepping Forward Therapy Services today on (03) 8609 1730 for an assessment by one of our experienced physiotherapists.
References
Medline Plus. (2013). Developmental Dysplasia of the Hip. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000971.html
Physiopedia. Developmental Dysplasia of the Hip (DDH). Retrieved from http://www.physio-pedia.com/Developmental_Dysplasia_of_the_Hip_(DDH)