Developmental dysplasia of the hip is a congenital
condition of the hip joint. It occurs once in every 1,000 live
births. The hip joint is normally created as a ball and socket
joint. In DDH, the hip socket may be shallow, letting the "ball"
of the femoral head slip in and out of the socket. The "ball"
may move partially or completely out of the hip socket.
The greatest incidence of DDH occurs in
first-born females with a history of a close relative with the
condition.
Hip dysplasia is considered a "multifactorial trait."
Multifactorial inheritance means that many factors are involved
in causing a birth defect. The factors are usually both genetic
and environmental.
Often, one gender (either male or female) is affected more
frequently than the other in multifactorial traits. Hip dysplasia is nine times more
common in females than males.
First-born babies are at higher risk since the uterus is small
and there is limited room for the baby to move; therefore
affecting the development of the hip. Other risk factors may
include the following:
-
Family history of developmental dysplasia of
the hip, or very flexible ligaments
-
Position of the baby in the uterus,
especially with breech presentations
-
Associations with other orthopaedic problems
that include metatarsus adductus, clubfoot deformity,
congenital conditions, and other syndromes
While newborn screening for DDH allows for early
detection of this hip condition, starting treatment immediately
after birth may be successful. Many babies respond to the Pavlik
harness, traction, and/or casting. Additional surgeries may be
necessary since the hip dislocation can reoccur as the child
grows and develops. If left untreated, the baby may have
differences in leg length, and may limp.
Left untreated, DDH or hip dysplasia leads to pain and
osteoarthritis by early adulthood. It may cause legs of
different lengths or a "duck-like" walk and decreased agility.
If dysplasia is treated successfully (and the earlier the
better) children end up with normal hip joint function, have no
further problems and go on to lead active lives. However, even
with appropriate treatment, especially in the child who is 2
years or older, hip deformity and osteoarthritis may develop
later in life.
Additional References about DHH:
DHH
Prevention of DHH
