Developmental Dysplasia of the Hip

Developmental Dysplasia of the Hip (Congenital Hip Dislocation)

Developmental dysplasia of the hip (DDH) is a dynamic condition and an orthopedic problem in which the structures forming the hip develop normally in the womb but later become structurally impaired for various reasons. In hip dislocation, the head of the femur is in the wrong position. It occurs as a result of the hip joint not developing properly in babies and young children. Hip dislocation is not always present at birth, which is why the term "developmental dysplasia of the hip (DDH)" is used today instead of congenital hip dislocation.

As the child grows, depending on various factors, it may resolve on its own or, less likely, get worse. Thanks to early diagnosis, the vast majority of DDH cases can be fully treated without any negative effect on the person's later life. When appropriate treatment is not received, this condition leads to a reduction in the average number of healthy life days in society, an increased burden on the social security system and serious losses in workforce productivity.

DDH is usually noticed during routine screening in early childhood.

Physical examination in the newborn period is very important.

All babies should be examined for hip dislocation in the newborn period (3–4 weeks), and if there is an abnormal finding or any of the risk factors, they should be referred to an orthopedics clinic for further tests and examination.

General Precautions

There is no effective way to prevent it.

Early detection is the most important thing.

Patients with hip dysplasia should have their children carefully examined at birth.

Risk factors

• Breech presentation at birth
• First child
• Multiple pregnancies
• Female sex
• Family history (the risk is increased in people with a family history)
• Low amniotic fluid
• Swaddling

Signs and Symptoms

Although no symptoms may appear during the first few years of life, possible signs include:

• A difference in length between the two legs,
• Limping in babies who walk (some babies move forward by dragging the affected leg)
• One hip joint moving differently from the other while walking,
• Limited movement of the hip joint,
• A clicking sound with hip joint movements,
• Inability to spread the legs outward,
• Asymmetry in the number and shape of the skin folds on the hips and legs,
• Delay in gross motor development (such as sitting, crawling and walking)

Diagnosis – Ultrasonography

Hip Ultrasound in Babies: Ultrasonography is used as a diagnostic tool for developmental dysplasia of the hip (DDH) in early infancy.

Treatment of Hip Dislocation in Babies

If the condition is diagnosed early, it can be treated without surgery.

In the first 6 months: treatment with only a splint and some simple measures

In babies older than 6 months: treatment with a surgical procedure under general anesthesia (the dislocated femoral head is put back in place). A cast is then required. After treatment, the patient is followed up, and any possible problems are addressed.

If treatment is given in the first 6 months, the rate of complete recovery is close to 100%.