Dysplasia of the hips is dislocation of the joint connecting the hip bone to the thigh. When this condition is seen in a baby it is termed as Developmental Dysplasia of the Hip, or DDH.
What is Developmental Dysplasia of the Hip?
Developmental Dysplasia of the Hip (DDH) is the term used to identify the hip joint dislocation in a child after birth. The hip joint is basically a ‘ball & socket’ type of joint. The upper end of the thigh bone (femur) is round like a ball. The hip has a spherical socket in which the ball end of the femur snugly fits. This joint is further supported by ligaments & tissues. In children suffering from DDH the hip joint shows signs of instability & faces a risk of easy dislocation.
Developmental Dysplasia of the Hip Symptoms
Symptoms of Developmental Dysplasia of the Hip normally include –
- Uneven length of legs – Leg on the affected side seems to be non proportionate.
- Abnormal skin folds on the thigh – Affected side might exhibit extra skin folds as the loose joint causes femur to shift.
- Limping, waddling or abnormal gait – Children suffering from DDH show an abnormal way of walking due to unevenness in length of the leg or because of the loose hip joint.
- One leg is less flexible or mobile – Affected leg seems to be stiff & lacks normal movement.
Types of Developmental Dysplasia of the Hip
Developmental Dysplasia of the Hip is a broad term used to identify a disorder of the hip bone in a child after birth. It is further divided to identify the exact disorder according to the severity of the dislocation.
- Subluxatable –It is a mild form of DDH. In this type the socket in the hip bone is larger than the ball end of the femur. This causes a slight gap between the ball & socket. In Subluxatable type of DDH the thigh bone can be moved inside the hip joint but some instability can also be felt.
- Dislocatable – In this kind of DDH the ball end of the femur is loosely fitted in the socket of the hip. It is in a weak position & faces the risk of total dislocation due to extreme stretching.
- Dislocated – In this most severe form of DDH the upper end of the femur is completely disjointed from the socket within the hip bone.
Developmental Dysplasia of the Hip Causes
- Hereditary -The main cause of most cases of DDH is found to be hereditary. There are more chances of a child to have DDH if the same disorder is seen in the parents or siblings.
- Ante Natal – Another cause of DDH is found to be the position of the baby in the mother’s womb. In the normal position there is no unnatural pressure on the baby’s hips. Although in cases of breech position of the child within the womb, hips are found to face undue amounts of pressure. This affects natural positioning of the hip joint in the baby.
- Mishandling – Baby’s bones at the time of birth are soft & pliable as they are formed mostly of cartilage as compared to hard bone of an adult. Hence, any injury or mishandling of the baby is more likely to cause DDH.
- Other Causes – Babies with feet deformity like fixed foot or stiffness in the neck (torticollis) are at a larger risk of DDH.
How is Developmental Dysplasia of the Hip Treated?
Doctors may use following types of tests to identify DDH in children –
- Visual Symptoms – Doctors can identify signs of DDH by a physical examination. In some cases, undue friction in the hip joint when the leg is moved in different positions is also checked.
- Imaging Tests – In a few cases doctors would recommend a few imaging tests like an ultrasound test or an x-ray test to confirm diagnosis & identify the type of DDH.
Treatment of Developmental Dysplasia of the Hip falls into two categories, namely Non-Surgical & Surgical. Type of treatment basically depends on the child’s age.
Non – Surgical Treatment
- Newborns – require a special harness called Pavlik harness for a period of 1 to 2 months. This harness is specially designed so as to keep the hip joint in a firm position without hindering normal movement of the leg. This harness is extremely useful in strengthening ligaments & muscle tissues around the hip joint & ensures its normal development.
- 1 to 6 Months – Children belonging to this age group also require a harness or similar device in order to strengthen the hip joint. In some cases doctors may also use an abduction brace to hold the joint firmly in place till it becomes normal. Certain cases would require the use of Spica Cast (body cast) which is used to hold the hip joint in place. This procedure is done under anesthesia so as to avoid discomfort to the baby.
- 6 Months to 2 Years – In older children doctors usually suggest use of spica cast or an abduction brace. Skin traction method is also used in some cases. In this the traction provides necessary strength to softer tissues around the hip joint & which keep it in a natural & normal position.
- 6 Months to 2 Years – When spica cast treatment is ineffective in aligning the hip joint into a normal position the doctor might suggest an open surgery. In this the surgeon will make an incision on the hip so as to get a better diagnosis of the problem. If required the surgeon would even shorten the ball end of the femur in a way which would make the ball end to snugly fit within the hip socket. Post surgery the baby will be required to wear a spica cast which will hold the joint in place.
- 2 Years & Above – Due to increased activity in children at this age, instability in the joint gets more pronounced. Hence, an open surgery is performed in order to properly place the thigh bone within the hip joint. Children are subsequently required to wear a body cast so as to keep the joint firmly in place.
Developmental Dysplasia of the Hip Treatment in India
As Development Dysplasia of the Hip affect children from birth to infancy, treatment is a delicate procedure requiring immense experience & application of modern techniques. Doctors & surgeons in India are well experienced in handling this condition with the latest medical technology at hand. Moreover, cost of Development Dysplasia of the Hip treatment & surgery in India is affordable. There are a number of world-class hospitals in most Indian major cities like Goa, Kerala, Mumbai, Pune, Bangalore, & Kolkata that cater to your every need of the patient. India has a robust network of medical centers and hospitals that are popular for people seeking treatment for DDH.Leave a reply →