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Pediatric DDH Surgery

Pediatric Developmental Dysplasia of Hip or DDH is basically an abnormal formation of hip joint wherein the ball at the top of the thighbone is unstable within the socket (acetabulum). This usually creates a problem with the way hip joints would develop as children grow. It is also found to be more common among girls. However, outcomes are usually excellent when DDH is diagnosed & treated early in young babies. But when treatments are delayed, DDH surgery turns out to be more complex & with lesser chance of successful outcomes.

Causes for Developmental Dysplasia of HipCauses of DDH are still not clear. However, there are several factors which are known to contribute to chances of a baby being born with this condition. Merely 1 baby among 75 babies with DDH risk factors is found to develop a dislocated hip. Common risk factors for DDH include the following.

  • Family History – When there is a parent, sister or brother with DDH, this makes it 5 times more likely that a baby may be having DDH at birth.
  • Gender – About 8 in every 10 cases of DDH are found to be females. This may be possible due to the fact that female hormone oestrogen is normally made by female fetuses in the womb itself. This hormone can make ligaments get stretchy & which eventually may mean that bones may move out of position.
  • Pregnancy Conditions – When there is a small amount of fluid within the uterus (womb), it is known as oligohydramnios. This condition can eventually increase risk of DDH as babies are unable to conveniently move about the uterus.
  • Breech Position – When unborn babies are in breech position, they can put their legs in a position which can increase risk of DDH. This is why most babies in breech position are born by caesarean section. These babies normally have risk of DDH which is 7 times higher than that of normal babies. Moreover, risk of breech babies vaginally delivered is about 17 times higher than that of normal babies.
  • First Born Babies – Almost 6 out of 10 cases of DDH are found to occur among firstborn babies. This could be due to the fact that uterus is less elastic & tighter that it would be in future pregnancies & which leaves less room for babies to move around.
  • Race – Risk of children having DDH is found to be much higher in certain races. Like for example, DDH is more common among Native American babies than it is among African American or Chinese children. This could partly be due to the position in which Native American babies are swaddled in.
  • Other Abnormalities – Babies also having cerebral palsy or spinal cord problems or other muscle & nerve disorders generally increase risk of developing DDH as well. Moreover, DDH is also more common among premature babies or among babies who were born weighing more than 5 kg.
  • DDH is found to occur in about 1 out of every 1,000 babies born.
  • DDH is more common in left hip.
  • In about 2 of every 10 cases, DDH affects both the hips.

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