Developmental dysplasia of the hip

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Developmental dysplasia of the hip

Developmental dysplasia of the hip (DDH) is a childhood condition caused by abnormal development of one or both hip joints. In DDH, the top of the thighbone (femur) does not fit securely into the hip socket (acetabulum).

DDH is the name for a range of conditions of the hip. In mild cases, the ligaments and other soft tissues around the hip joint are not tight, and they allow the thighbone (femur) to move around more than normal in the hip socket. In more severe cases, the joint is loose enough to let the thighbone come partway out of the hip socket. This is called subluxation. Actual "dysplasia" is the most severe form of the condition. If a child has hip dysplasia, the socket is too shallow, more like a saucer than the deep cup that it should be. This allows the ball at the top of the thighbone (femoral head) to either partly or fully slip out of the socket (dislocate).

A baby with DDH may have:

• A hip joint that feels loose or slips out of place when examined.
• One thigh that appears shorter than the other.
• Extra folds of skin on the inside of the thigh(s).
• A hip joint that moves differently than the other.

A child who is walking may walk on the toes of one foot with the heel up off the floor or walk with a limp (or with a waddling gait if both hips are affected).

DDH is often treated by moving the upper thighbone into its normal position and keeping it in place while the joint grows. A device called a Pavlik harness is most often used to keep the joint in place in babies younger than 6 months. A hard cast (spica cast) is used for older babies. Other forms of treatment, such as surgery or a brace, also may be needed.

Credits

Last updated:	May 25, 2007
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Kathleen Romito, MD - Family Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman