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Developmental Dysplasia of the Hip (DDH)

Pavlick Harness2DDH 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.

 
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References

Medline Plus. (2013). Developmental Dysplasia of the Hip. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000971.htm

 

Physiopedia. Developmental Dysplasia of the Hip (DDH). Retrieved from http://www.physio-pedia.com/Developmental_Dysplasia_of_the_Hip_(DDH)

 

Article written by Nikki Ceeney

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