Developmental Dislocation of the Hip

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Developmental dislocation of the hip, more commonly know as DDH, is synonymous with congenital dislocation of the hip (CDH). This is a pediatric orthopedic problem in which a newborn or toddler is discovered to have a hip (occasionally bilaterally-20%) that is not in the socket; this is termed subluxed (partial contact with the pelvis) or dislocated (no contact with the pelvis). The incidence is approximately 1:1000 live births. Girls have a 6:1 ratio of presentation compared to boys. A breech presentation also is a risk factor for DDH. DDH should not be confused with teratologic hip dislocation, which is diagnosed in-utero.

The cause of DDH is thought to be associated with in-utero positioning of the fetus; other commonly linked conditions include torticollis and metatarsus adductus.

If left untreated, or undiagnosed, DDH can lead to the development of both hip dysplasia and osteoarthritis later in life, as well as painful disability and a limp.

DDH is usually suspected when a pediatrician examines the child during a well baby exam; formal diagnosis is then made by ultrasound and/or radiographs (xrays), at which point pediatric orthopedic consultation and referral is sought.

Treatment of DDH includes non-operative (bracing, harness) and operative means (specialized osteotomies).

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