Developmental Dysplasia of the Hip (DDH) is typically a childhood arthritis disease. It is also known as congenital hip dislocation. It can occur at any time from fetal joint formation to complete joint maturity.
The hip joint is a ball and socket type of joint. The circle-shaped head of the femur is fixed flexibly on a proportionally cup-shaped anatomical structure called the acetabulum.
The definition of DDH is not well established but can generally be attributed to dislocation of the hip joint.
Causes of Developmental Dysplasia of the Hip
Depending on the level of attachment of the head of femur to the acetabulum, DDH can be classified into 3 different categories:
- Dislocation: the head of the femur is removed from the acetabulum.
- Incomplete dislocation: loose attachment of the head of femur to the acetabulum. The head of femur can move in and out of the joint socket.
- Subluxation: the head of femur is not firmly attached to the acetabulum and therefore moves within the acetabulum. In this category, the head of femur cannot slide out of the acetabulum.
The etiological factors of DDH have not been well developed. In infants, DDH results from a shallow-shaped acetabulum and overstretching of the ligaments in the hip joint. However, the following risk factors predispose an individual to develop DDH:
- Hereditary factors e.g. parent or sibling
- Female sex
- First born
- Oligohydramnios i.e. low levels of amniotic fluid
- Large birth weight >3500gms
Symptoms of Developmental Dysplasia of the Hip
Because this type of arthritis occurs predominantly in the first year of life, understanding the nature of the symptoms is challenging. We can rely on what we visibly see from a child.
- Discomfort may be severe enough to cause episodes of inconsolable crying
- Leg lengths tend to vary
- The skin around the affected joint tends to fold
- There’s diminished flexibility in the affected joint
- The lower back tends to form a rounding shape
Treatment of Developmental Dysplasia of the Hip
There are several methods to correct hip joint dislocation. Realigning the hip joint requires a doctor with skills, experience and expertise in managing DDH. Not just any orthopedic surgeon can perform the right corrective therapy in hip joint dislocation. This is why we recommend Dr. Burke, an orthopedic surgeon who has performed dozens of hip joint realignment procedures both invasively and no-invasively. These are the treatment modalities offered by Dr. Burke:
- Braces: Pavlik harness
- Closed reduction with or without a body cast
- Skin traction
- Open reduction