Hip dysplasia, formally known as developmental dysplasia of the hip (DDH), is a congenital condition affecting the hip joint. Hip dysplasia treatment during infancy most often results in normal hip function.
The hip is a ball-and-socket joint. The top of the thigh bone, called the femoral head, is the "ball," and the pelvis forms the "socket." Congenital hip dysplasia occurs when this joint does not form properly and the femoral head slides out of the joint.
Genetic factors may play a role in the development of hip dysplasia. The defect does not follow strict genetic inheritance, but it does tend to run in families. The infant who is at highest risk of hip dysplasia:
Hip dysplasia symptoms include:
All infants born in hospitals are screened for hip dysplasia at birth. The outward appearance of the hips and legs is an indicator, and the manipulation of the hips may produce a clicking or popping sound as the femoral head moves abnormally in and out of the socket. Imaging tests, such as x-ray and magnetic resonance imaging (MRI), may be used to confirm a diagnosis.
Hip dysplasia may present with varying levels of severity. The femoral head may be partially or completely displaced from the socket. The hip joints may be affected unilaterally (one side) or bilaterally (both sides).
Hip dysplasia can be treated in two ways, depending on its severity. A Pavlik harness is a brace that holds an infant's legs in place, partially immobilizing the hips. It is usually worn full-time for six weeks, and then part-time for another six weeks. This procedure treats some cases of hip dysplasia successfully.
More severe or resistant cases require additional treatment. Traction is applied to the hip to re-align the joint. A metal frame holds a series of weights and pulleys attached to specific parts of the legs and hip to stretch the soft tissue around the hip joint, moving the femoral head back into the socket.
Other cases may require surgical intervention and casting of the hip to change the placement of the hip joint and ensure the hip remains in the new position.
Early diagnosis is an important factor in hip dysplasia treatment. Treatment in early infancy is usually successful with few complications. However, later treatment, after the body has continued to grow and develop, presents more challenges and a greater risk of complications. These late-treated cases are more likely to require surgical intervention. Untreated dysplasia of hip joints can lead to early arthritis of the hip.
Children's Hospital Boston. (n.d.). Developmental dysplasia of the hip (DDH).Retrieved April 27, 2010, from: http://www.childrenshospital.org/az/Site706/mainpageS706P0.html.
International Hip Dysplasia Institute. (n.d.). Hip dysplasia: what is it? Retrieved April 27, 2010, from: http://www.hip-baby.org/.
Lucille Packard Children's Hospital at Stanford. (n.d.). Developmental dysplasia of the hip. Retrieved April 27, 2010, from: http://www.lpch.org/diseaseHealthInfo/HealthLibrary/orthopaedics/ddh.html.
Medline Plus. (n.d.). Developmental dysplasia of the hip.Retrieved April 27, 2010, from: http://www.nlm.nih.gov/medlineplus/ency/article/000971.htm.
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