Pediatric Hip Dysplasia: Symptoms, Prevention and Treatment

What is Pediatric Developmental Dysplasia of the Hip (DDH)?

Developmental dysplasia of the hip, or DDH, is also called as congenital hip dysplasia and is quite common in some children and infants. It is not a sudden-occurring disorder rather it progresses slowly as the affected child grows. The DDH disorder can either start in the uterus of the mother or develop later on in the first year of the child’s life.

DDH is recognized as the abnormality in the child’s hip joint and can be mild to severe in nature. Instability (weakness) in the hip joint of the child has a risk of facing dislocation as well. More severe form of DDH can result in partial or complete dislocation as the disorder reaches its severe stages with time.

What are the Signs and Symptoms of DDH?

Signs And Symptoms of DDH

These are the some of the signs and symptoms that are helpful in recognizing if a child is suffering from DDH.

Asymmetry

Asymmetry in the buttock levels can be seen in a child suffering from DDH. This can be confirmed with an x-ray test or an ultrasound test.

Hip Click

A sound like a ‘click’ or a ‘pop’ is usually heard when the child’s legs are moved in an outward motion, this may suggest DDH. However, an extensive diagnostic test is more reliable as the clicking or popping sound is also caused by developing ligaments in a normal child’s hips.

Limited Motion

The child’s range of movement in the hip gets restricted and the legs cannot be spread to normal extent outwards. This is a more recognizable symptom of DDH in a child.

Limb Length Discrepancy

The child’s leg may seem to be of different lengths and are more noticeable.

Uneven Skin Formation

The child’s thigh skin may show unevenness in the formation and there is a marked difference to be seen.

Rigidity

The child’s hip motions are restricted and one side may show less flexibility.

Uneven Gait

The child’s gait shows remarkable unevenness, such as limping, waddling or walking in the toe.

What is the Anatomy of the Hip Joint?

A hip joint is one of the most important joints in the human body as it connects the upper body (torso) to the lower body (legs). The hip joint is comprised of the upper part of the femur (thigh bone) and the acetabulum (pelvic bone). The upper end of the femur is shaped into a ball (femoral head) that fits snugly in the socket part of the acetabulum in the pelvic region. The ball and socket joint allows the leg to be moved in a rotational manner.

There is a layer of cartilage tissues between the femoral head and the acetabulum that acts as a lubricant and prevents the end of the bones to rub against each other. For a child suffering from DDH the femoral head and the acetabulum do not get fitted normally and are somewhat loose which results in easy dislocation. DDH causes the acetabulum in the growing child to become deformed and the femoral head does not fit normally. The extent of the displacement signifies the severity of DDH in a child.

Types of DDH

Subluxatable

This is a milder form of DDH in which the femoral head is loosely fitted within the acetabulum. Movement in a particular motion can make you feel the loose fit of the femoral head.

Dislocatable

This is a slightly more severe form of DDH as the femoral head lies within the acetabulum but a slight pressure may cause it to become dislocated.

Dislocated

This is the most severe case of DDH in which the femoral head is completely dislocated out of the acetabulum socket.

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What causes DDH in a child?

Developmental dysplasia of the hip can be caused for a number of reasons, such as:

  • Weak ligaments of the hip joint.
  • A ‘breach position’ in the uterus puts undue pressure on the hip joint of the fetus and can hinder normal development after birth.
  • Swaddling, or wrapping the child with the legs tightly held together, may often result in abnormal growth of the acetabulum.
  • Other developmental disabilities are also known to cause DDH.

How to prevent Developmental Dysplasia of the Hip (DDH) in a child?

Prevention of DDH

The main causes of DDH are often found to be in the later stages of pregnancy or the earlier years after birth.

Here are a few tips that can help you prevent DDH in a child:

Swaddling

Improper swaddling, or wrapping, a baby after birth regularly is known to cause DDH in a child. Doctors suggest that the parent should be careful and avoid improper swaddling to prevent DDH in a child.

Sudden straightening of the newborn’s legs may cause dislocation of the hip joint. The suggested way for proper swaddling of a child is with the legs bent and out at the hips instead of putting the legs straight and together.

Baby wearing

Wearing a baby close to the body is becoming increasingly popular and care should be taken while baby wearing as an improper positioning for a long period of time can cause the baby’s hip joint to become loose and increase the chances of dislocation.

The baby should be carried with the legs spread from the hips and bent at the knees so the knees are usually higher in position than the hips.

Baby carrying products

There are a number of products available that are designed for carrying a baby such as a baby carrier, infant car seat, walkers, swings and other equipments.

The best way to choose a baby carrying equipment is the one that allows the normal positioning of the hip. The baby carrier should allow the baby’s legs to be spread outwards from the hip as well as provide firm support to the thighs.

How is DDH diagnosed?

Earliest detection of the DDH in a child increases the chances of treatment significantly. The most important form of diagnosis is the physical examination performed by the pediatrician.

There are two vital diagnostic examinations to detect the presence of DDH in a newborn child:

Ortolani’s Maneuver

This physical test involves placing the baby on its back on a flat surface and spreading the baby’s legs with the knees bent in an outward motion. The doctor will look for signs of easy dislocation of the femoral head from the baby’s acetabulum.

Allis’s Test

In this physical examination the doctor will place the baby on its back with the knees bent and the feet placed flat on the surface. This allows the doctor to check for uneven knee positioning. If the baby’s knees are found to be uneven (one shorter than the other) the doctor can diagnose the presence of DDH in the baby.

Why Choose India to get Treatment of Developmental Dysplasia of the Hip (DDH)?

It is imperative to diagnose the presence of DDH at an earliest stage so the proper and most efficient treatment method can be used to correct this disorder. The pediatric specialists and doctors in India have a vast experience and an extensive training in detecting the early symptoms of DDH and performing a number of effective treatment methods to prevent and correct the disorder. Indian pediatric specialists have a very high rate of success. The vast network of specialty hospitals and pediatric clinics in India is equipped with the most modern diagnostic and treatment equipment which further adds to the success factor.

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