Developmental Dysplasia of the Hip or DDH describes a condition where the hip joint does not develop normally.
The hip joint is formed of the thigh bone (femur), which has a ball shaped head. This fits into the pelvis, a cup shaped socket called the acetabulum. DDH occurs when the cup shaped socket is shallow and does not hold the ball/head of the thigh bone in place allowing it to slip or completely dislocate. In many cases DDH may be present at birth however, the hip may be stable at birth and then develop abnormally as the baby grows.
The following are common risk factors associated with DDH:
- Breech presentation
- Family history of DDH
- Foot deformities – e.g. Talipes
- Reduced amniotic fluid in the uterus
- Birth weight of over 4Kg (9lbs)
Symptoms of DDH
DDH is not painful and there are no definite signs but you may notice the following:
- One leg may look shorter than the other.
- An extra deep crease on the inside of the thigh.
- One leg moves differently from the other and the knee may appear to face outwards.
- When you change your baby’s nappy one leg does not seem to move outwards as fully as the other.
- If it is not detected at birth you may notice when your child starts to walk that they walk with a limp
How is DDH detected?
Babies will have a hip check following birth by a paediatrician or midwife. If the hip is found to “click” or is unstable they will be referred for an ultrasound of the hip and reviewed by an orthopaedic team.
If your baby’s hip are found to be unstable or dislocated then they will wear a soft harness that holds the legs in a bent position to encourage the cup shaped socket to mold to the femur head. It is usually worn for 16-18 weeks and will be regularly monitored by the hospital. The harness is normally worn for 23 hours a day.
If your baby does not respond to treatment in a harness or it is not detected at a later stage, they may need an operation and a period of time in plaster (hip spica) for several months.
Following treatment it is important to get a physiotherapy assessment to evaluate the areas of muscle weakness and the hip range of movement. Also your baby is at risk of falling behind in their development and our specialist physiotherapists can provide you with advice to encourage development of their gross motor skills e.g. crawling and walking.
Are you looking for a specialist paediatric physiotherapist to assess your child’s DDH? We are able to see your child at home and can often arrange an appointment within 24 hours. Contact us today on 0207 884 0374 or email email@example.com.