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Congenital hip dysplasia is an abnormal formation of the hip joint in which the ball at
the top of the thighbone (femoral head) is not stable in the socket (acetabulum). Also,
the ligaments of the hip joint may be loose and stretched. The degree of instability or
looseness varies. A baby born with DDH may have the ball of his or her hip loosely in
the socket, the looseness may worsen as the child grows and becomes more active, or
the ball may be completely dislocated at birth.
Left untreated, DDH or Congenital hip dysplasia leads to pain and osteoarthritis by
early adulthood. It may cause legs of different lengths or a "duck-like" walk and
decreased agility. DDH has a familial tendency. It usually affects the left hip and is
predominant in:
Girls.
First born children.
babies born in the breech position (especially with feet up by the shoulders).
In children who have begun to walk, limping, toe walking and a waddling "duck-like"
gait are also signs.
In addition to visual clues, doctors use careful physical examination tests to check for
subtle signs of hip instability or dislocation in babies, such as listening and feeling for
"clunks." Hip X-rays also may be helpful in older infants and children.
Treatment methods depend upon the childs age.
the muscles have contracted in that position. Also in older infants, hip dislocation is
evident if one leg looks shorter than the other.
X-ray films can be helpful in detecting abnormal findings of the hip joint. X rays may
also be helpful in finding the proper positioning of the hip joint for treatments of
casting. Ultrasound has been noted as a safe and effective tool for the diagnosis of
congenital Congenital hip dysplasia. Ultrasound has advantages over x rays, as several
positions are noted during the ultrasound procedure. This is in contrast to only one
position observed during the x ray.
Prognosis
Unless corrected soon after birth, abnormal stresses cause malformation of the
developing femur, with a characteristic limp or waddling gait. If cases of congenital
Congenital hip dysplasia go untreated, the child will have difficulty walking , which
could result in life-long pain. In addition, if this condition goes untreated, the
abnormal hip positioning will force the acetabulum to locate to another position to
accommodate the displaced femur.
Prevention
Prevention includes proper prenatal care to determine the position of the baby in the
womb. This may be helpful in preparing for possible breech births associated with hip
problems. Avoiding excessive and prolonged infant hip adduction may help prevent
strain on the hip joints. Early diagnosis remains an important part of prevention of
congenital Congenital hip dysplasia.
over to the placenta and cause the baby to have lax ligaments while still in the womb.
Other symptoms of complete dislocation include a shortening of the leg and limited
ability to abduct the leg.
the legs apart and forcing the head of the femur into the acetabulum. In some cases, in
older children between six to 18 months, surgery may be necessary to reposition the
joint. Also at this age, the use of closed manipulation may be applied successfully, by
moving the leg around manually to replace joint. Operations are not only performed to
reduce the dislocation of the hip, but also to repair a defect in the acetabulum. A cast
is applied after the operation to hold the head of the femur in the correct position. The
use of a home traction program is now more common. However, after the age of eight
years, surgical procedures are primarily done for pain reduction measures only. Total
hip surgeries may be inevitable later in adulthood.