Developmental dysplasia of the hip ddh is a condition where the ball and socket joint of the hip does not properly form in babies and young children. The condition is found in babies or young children. Developmental dysplasia of the hip is usually suspected in the early neonatal period due to the widespread adoption of clinical examination including the ortolani test, barlow maneuvers, and galeazzi sign. Movements at the joint include flexion, extension, abduction, adduction, medial and lateral rotation, and circumduction. Screening for developmental dysplasia of the hip chapter 1. Developmental dysplasia of the hip is a condition of the hip joint that occurs once in every 1,000 live births. In a normal hip, the ball at the upper end of the thighbone femur fits firmly into the socket, which is part of the large pelvis bone. Doctors use a number of different terms for hip dysplasia. It should be in the cupshaped socket of the pelvis called the acetabulum. The upper end of the femur is shaped into a ball femoral head that fits into a socket the acetabulum. The ihdi is here to help you find answers to your questions when dealing with hip dysplasia. Its caused by abnormal formation of the hip joint during their early stages of fetal development.
Developmental dysplasia of the hip, also referred to as ddh, is a condition in which the hip joint develops abnormally. Tendons and muscles hold the femoral head in the socket. Total hip arthroplasty in adolescents and young adults. The ball at the top of the thighbone called the femoral head is not in the right place. Developmental dysplasia of the hip ddh better health. Ddh refers to a spectrum of severity ranging from mild acetabular dysplasia.
Hip dysplasia is an abnormality of the hip joint where the socket portion does not fully cover the. Developmental dysplasia of the hip ddh refers to hip instability, subluxation dislocation of the femoral head, andor acetabular dysplasia in a developing hip joint. The use of an abduction device allows maintenance of hip location, and the pavlik harness has become established ahead of rigid splints. The change in name reflects the fact that ddh is a developmental process that occurs over time. Evidence synthesis number 42 screening for developmental dysplasia of the hip prepared for. Answers to your questions about developmental dysplasia of the hip ddh, also known as hip dysplasia, in humans. The etiology is not yet fully understood but a breech presentation and family history of ddh are the most important risk factors. The child should be dysplasia of the hip flexed 90 as well as abducted and treat examined at regular intervals to ensure the ment is continued until the hip is stable, as reduction. Sep 23, 2010 developmental dysplasia of the hip ddh is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Developmental dysplasia of the hip, or ddh, means that the hip joint of a newborn baby is dislocated or prone to dislocation. The general treatment principle of ddh is to obtain and maintain a concentric reduction of the femoral head in the acetabulum. Developmental dysplasia of the hip musculoskeletal. Doctors use a number of different terms for hip dysplasia depending on severity and. Developmental dysplasia of the hip ddh is common, ranging from mild dysplasia to frank dislocation.
Developmental dysplasia of the hip is a challenging condition that represents a state of deformity and slow development of the hip joint in early childhood 1, 2. Treatment includes special harnesses, or operations and casts, depending on the age of. 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. Developmental dysplasia of the hip ddh what is ddh. Treatment varies from pavlik bracing to surgical reduction and osteotomies depending on the age of the patient and degree of dysplasia. Developmental dysplasia of the hip ddh is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation. Developmental dysplasia of the hip ddh is a congenital disorder of the hip resulting in deformity in both the femoral head and acetabulum that can progress to secondary osteoarthritis in the undertreated or untreated patient fig. Developmental dysplasia of the hip brenner childrens. Developmental dysplasia of the hip ddh is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Developmental dysplasia of the hip ddh pediatrics orthobullets. Early recognition and treatment are important to prevent hip related complications later in life. Congenital hip dislocation chd occurs when a child is born with an unstable hip. Secondary hip dysplasia may occur in the absence of persistent instability in the growing hip, hence the more recent term developmental dysplasia of the hip ddh.
If this is not successful or the developmental dysplasia of the hip is diagnosed later in life, surgery is necessary to reconstruct the hip joint. Ortolani test for a neonates hip developmental dislocation. Its sometimes called congenital hip dislocation or hip dysplasia. Screening for developmental dysplasia of the hip u. The hip joint is made up of the thigh bone the femur and the pelvic bone. Hip dysplasia into teens and later life may result in irregular gait, reduced the strength and generate many hip and knee disease. Hip developmental dysplasia childrens hospital colorado. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Hip dysplasia or ddh is normally diagnosed in babies however it can develop later on. The normal hip joint is created as a ball and socket joint in which the ball is usually completely covered by the socket. It is easier for a babys or infants hip to become misaligned or dislocated because their hip sockets are developing and are still made of soft and pliable cartilage. Developmental dysplasia of the hip ddh international hip.
Other names can also be used to describe this condition, including congenital dysplasia of the hip, or congenital dislocation of the hip. Developmental dysplasia of the hip includes frank dislocation luxation, partial dislocation subluxation, instability wherein the femoral head comes in and out of the socket, and an array of. This disorder underlies up to 9% of all primary hip replacements and up to 29% of those in people aged 60 years and younger. Developmental hip dysplasia diagnosis at threedimensional. Graf pioneered the use of usg for the evaluation of infant hip. Developmental dysplasia of the hip juniper publishers. Developmental dysplasia of the hip for parents primary. Developmental dysplasia of the hip learning resource. This report may be used, in whole or in part, as the basis for development of clinical. Regardless, it does not typically produce symptoms in babies less than a year old. Developmental dysplasia of the hip ddh is the name for a range of conditions of a childs hip. A patients guide to developmental dysplasia of the hip in children introduction. A natural animal model for human developmental dysplasia of the hip cecilia pascualgarrido,1 farshid guilak,1,2 m.
Hip dysplasia is often referred to as developmental dysplasia of the hip or ddh and is generally the preferred term for babies and children with hip dysplasia since this condition can develop after birth. Developmental dysplasia of the hip knowledge for medical. The hip joint attaches the thigh bone femur to the pelvis. Developmental dysplasia of the hip ddh is an abnormal development of the hip joint. Anatomy of hip joint it is a multiaxial ball and socket joint designed for stability and weight bearing. Ddh affects one in every 600 girls, and one in every 3,000 boys. Developmental dysplasia of the hip ddh is a dislocation of the hip joint that is present at birth. The key words used were saudi arabia developmental dysplasia of the hip orddh, congenital hip dislocation or congenital subluxation of the hip, and congenital dysplasia of the hip. The hip is a ballandsocket type joint, formed by the round head of femur and a cupshaped socket acetabulum figure 1.
Although it may be associated with various neuromuscular disorders, such as myelodysplasia, or occur in utero, it most commonly occurs in neurologically normal infants and is multifactorial in origin. We operate a selective ultrasound screening policy in nottingham performing ultrasound assessment of babies with clinical concerns over ddh or risk factors. General overview displacement of the head of the femur out of the acetabulum occurs at or after conception 1,2. Due to the position of the babys hip in relation to the mothers spine while the baby is in utero, the left hip is affected the majority of the time developmental hip instability, which includes dysplasia, is estimated to. He proposed classification system on the basis angle formed by sonographic structures of hip. Feb 06, 2020 the term congenital dislocation of the hip dates back to the time of hippocrates. Jan 02, 2020 hip dysplasia is treated by placing the baby in a harness or brace for a period of a few months to keep the legs in the correct position to allow the hips to form normally. Hip dysplasia is an abnormality of the hip joint where the socket portion does not fully cover the ball portion, resulting in an increased risk for joint dislocation.
Oct 15, 2006 developmental dysplasia of the hip refers to a continuum of abnormalities in the immature hip that can range from subtle dysplasia to dislocation. Developmental dysplasia of the hip american family physician. Nov 24, 2009 developmental dysplasia of the hip affects % of newborns. Developmental dysplasia of the hip affects % of newborns. Early recognition and treatment are important to prevent hiprelated complications later in life. Developmental dysplasia of the hip free download as powerpoint presentation. Developmental dysplasia of the hip or congenital hip. The total hip registry from the authors institution. The treatment depends on the age at presentation and the amount of dysplasia of the hip.
Diagnosis and management of developmental hip dysplasia. Developmental dysplasia of the hip, part i diagnosis medscape nov 21, 2001. Developmental dysplasia of the hip ddh is a problem with the way a babys hip joint forms before, during, or after birth causing an unstable hip. Treatment includes special harnesses, or operations and casts, depending on the age of the child at diagnosis. This condition, also known as hip dysplasia or developmental dysplasia of the hip ddh, has been diagnosed and treated for several hundred years. Different diagnostics test for developmental dysplasia of hip were invented to treat with this condition. Neonatal hip instability is ideally diagnosed early and treated appropriately. Developmental displasia of the hip ddh merupakan kelainan yang seringkali menyebabkan.
In severe cases, the hip joint can dislocate or cause trouble walking. The authors identified 18 potentially relevant articles published in the last 38 years, and 10 met the inclusion criteria. Developmental dysplasia of the hip american academy of. Mild cases of ddh usually get better on their own as a baby grows. Department of health and human services agency for healthcare research and quality. The management of hip dysplasia is age dependent, and can be divided into neonatal, early and late groups. If this is not successful or the developmental dysplasia of the hip is diagnosed. Identical twins are more prone to development of hip dysplasia than fraternal twins. The term congenital dislocation of the hip dates back to the time of hippocrates. In babies and children with developmental dysplasia dislocation of the hip ddh, the hip joint has not formed normally. Developmental dysplasia of the hip musculoskeletal system. Developmental dysplasia of the hip ddh is a common and important topic in pediatric orthopedics.
The diagnosis can be difficult, even in experienced. The ball is loose in the socket and may dislocate easily. Developmental dysplasia of the hip ddh, previously known as congenital hip dysplasia is a common disorder affecting infants and young children. Developmental dysplasia of the hip ddh is a deformity of the hip that can happen before, during, or weeks after birth. Developmental dysplasia of the hip, part i medscape. The diagnosis is then usually confirmed with ultrasound, although the role of ultrasound in screening is controversial 1,3. Developmental dislocation dysplasia of the hip ddh. Hold knees and gently abduct one hip at a time while lifting greater trochanter with two fingers. Screening for this condition is of utmost importance. Developmental dysplasia of the hip or congenital hip dislocation imaging october 2012 kevin bender jeremy campbell kirsten caulfield general overview. Ddh is a medical term for general instability, or looseness, of the hip joint. Developmental dysplasia of the hip ddh developmental dysplasia of the hip ddh is a condition that affects the hip joint in babies and young children. Pediatricians are often the first to identify developmental dysplasia of the hip ddh and direct subsequent appropriate treatment. Developmental dysplasia of the hip is an important cause of childhood disability.
Developmental dysplasia of the hip ddh, found in 1. Dec 18, 2016 to determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis oa or sequelae of developmental dysplasia of the hip ddh. Ddh is a term used to describe a spectrum of abnormalities affecting the relationship of the femoral head to the acetabulum. In children with ddh, the ball at the top of the thigh bone called the head of the femur bone is not stable within the socket called the acetabulum. Developmental dysplasia of the hip ddh in saudi arabia. Sep 23, 2016 developmental dysplasia of the hip ddh was formerly referred to as congenital dislocation of the hip cdh. Threedimensional 3d us is at least equivalent to twodimensional 2d us in diagnostic accuracy for developmental hip dysplasia, with advantages including a fourfold reduction in the number of patients with inconclusive borderline results who require followup imaging. The ligaments of the hip joint that hold it together may also be loose. Infant diagnosis international hip dysplasia institute. Hip dysplasia may occur at birth or develop in early life. You have been asked to rule out developmental dysplasia of the hip ddh. Other names, developmental dysplasia of the hip ddh, developmental dislocation of the.
Ddh occurs when a babys hip joint does not grow normally. Developmental dysplasia of the hip refers to a range of conditions that can affect the development of the hips in infants or young children. Sometimes the condition starts before the baby is born, and sometimes it happens after birth, as the child grows. The term congenital dislocation of the hip cdh describes a spectrum of abnormalities of the hip joint, from capsular laxity or mild acetabular dysplasia to established dislocation. Clohisy1 1department of orthopaedic surgery, school of medicine, musculoskeletal research center, washington university, 660 s. Developmental dysplasia of the hip ddh is a problem with the way a babys hip joint forms. Because treatment by pavlik harness is highly effective, prompt and accurate diagnosis of ddh in infants could substantially reduce the longterm morbidity of ddh. Developmental dysplasia of the hip ddh is a condition that affects the neonatal and infant hip joint. Ddh is now the preferred term to reflect that ddh is an ongoing developmental process, which is variable in presentation and not always detectable at birth. Developmental dysplasia of the hip ddh is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation of the hip secondary to capsular laxity and mechanical factors. Recognize the presentation of hip dislocation in the older child.
Developmental dysplasia of the hip ddh is the most common paediatric hip condition, affecting 0. Management of developmental ly applied, they allow motion while the hips are orthosis with ap xray. Developmental dysplasia of the hip radiology reference. Displasia panggul atau ddh developmental dysplasia of hip merupakan perkembangan abnormal panggul berupa displasia, subluksasi, dan dislokasi sendi. Developmental hip dysplasia diagnosis at threedimensional us. Daniel joseph augustine mosc medical college, kolenchery 2. Hip dysplasia is treated by placing the baby in a harness or brace for a period of a few months to keep the legs in the correct position to allow the hips to form normally. This condition, also known as hip dysplasia or developmental. Developmental dysplasia of the hip refers to a continuum of abnormalities in the immature hip that can range from subtle dysplasia to dislocation. Developmental dysplasia should be treated soon after death.
220 536 1230 866 1226 1057 1152 1457 1477 298 277 318 1410 1037 939 1116 113 180 1486 1500 89 586 60 812 1006 540 25 981 384 541 1310 1297