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Developmental Dysplasia of the Hip

(DDH; Congenital Dysplasia/Dislocation of the Hip [CDH]; Congenital Dysplasia of the Hip; Congenital Dislocation of the Hip; Congenital Subluxability of the Hip; Congenital Hip Dysplasia; Congenital Hip Dislocation; Congenital Hip Subluxability; Dysplasia of the Hip, Developmental)

Definition

The hip is where the thigh bone and pelvis meet. The thigh bone has a ball-shaped top. This ball fits into a cup-shaped area on the pelvis. Developmental dysplasia of the hip (DDH) is a problem with how these bones fit together. The exact problem can vary between children but may include:
The Hip Joint
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Causes

The exact cause of DDH is not known. Some factors that may play a role include:
Certain carrying or wrapping techniques may also affect the growth of the hip, especially methods that have the child tightly bound in a position with the hips straight out and turned in.

Risk Factors

DDH is more common in females. Other factors that may increase your baby’s chance of developing DDH include:

Symptoms

DDH can make the hip unstable and loose. Symptoms may depend on the age of your child. They may include:
DDH more commonly affects the left hip. Sometimes both hip joints are affected. The condition may be detected when the baby is born.

Diagnosis

Your child's doctor will look for signs of DDH during the first physical exam, and every exam in the first year. The hip will be stressed gently to see if it moves, or makes a clunking or popping noise. This may indicate a dislocating hip.
The hip may also be assessed with:
Detailed pictures of the hip may help confirm the diagnosis or determine treatment. The pictures can be made with:

Treatment

Talk with the doctor about the best treatment plan for your baby. Depending on your baby’s age and the severity of the condition, treatment options include:
If your baby was diagnosed with DDH at birth, the doctor may not treat the condition until the baby is older than 2 weeks. Early DDH may improve on its own.
The doctor will monitor the hip during follow-up exams and x-rays. This will be done until your child is done growing.

Prevention

Because the exact cause is unknown, it is difficult to prevent DDH. If you are pregnant and have a family history of DDH, tell your doctor.
Avoiding certain swaddling positions may also help decrease some types of hip dislocation.

RESOURCES

OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

CANADIAN RESOURCES

Canadian Institute of Child Health http://www.cich.ca

Canadian Paediatric Society http://www.cps.ca

References

Developmental dysplasia of the hip. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00347. Updated October 2013. Accessed February 11, 2016.

Developmental dysplasia of the hip. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 21, 2015. Accessed February 11, 2016.

Hart ES, Albright MB, et al. Developmental dysplasia of the hip: nursing implications and anticipatory guidance for parents. Orthopaedic Nursing. 2006;25:100-111.

Shorter D, Hong T, et al. Screening programmes for developmental dysplasia of the hip in newborn infants. Cochrane Database Syst Rev. 2011;9:CD004595.

1/20/2015 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Academy of Orthopaedic Surgeons (AAOS). American Academy of Orthopaedic Surgeons clinical practice guideline on detection and nonoperative management of pediatric developmental dysplasia of the hip in infants up to six months of age. Rosemont (IL): American Academy of Orthopaedic Surgeons (AAOS); 2014 Sep 5. 368. Available at: http://www.guideline.gov/content.aspx?id=48516#Section420. Accessed February 11, 2016.

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