Hip dysplasia (developmental dysplasia of the hip or DDH) occurs when the hip socket does not fully cover the ball of the hip joint, allowing it to become partially or completely dislocated. This failure of the hip joints to develop normally results in gradual deterioration, leading to loss of joint function and arthritis. The symptoms of dysplasia are very subtle in infants and young children up to about age eleven, because the child typically feels no pain associated with the condition. Before a baby starts to walk, symptoms may include:
After a child begins to walk, parents may notice a lurching or waddling gait or a limp, none of which are accompanied by pain. Older children (11 and up) and young adults with hip dysplasia often develop pain they have not felt earlier, although the condition may have been present since birth. Patients may have been treated for hip dysplasia as babies, but in most cases have not been previously diagnosed or treated. The cause may also be a hip injury or other childhood problem that results in delayed complications.
Early awareness of hip dysplasia is extremely important because the best opportunity for minimally invasive treatment is when the condition is diagnosed before a child starts to walk. Screening as early as possible is advised for babies with a family medical history of DDH, placing them at a higher risk, or those who display any of the symptoms of dysplasia.
A physical exam by a pediatrician or orthopedist may include an ultrasound scan for babies up to 4 months old; after 4 months, X-rays are generally used to spot dysplasia in bones that are more developed.
Treatment of hip dysplasia in young children depends almost entirely on the child’s age at diagnosis. The earlier it’s detected, the less invasive the necessary treatment; for babies, a soft brace, harness, body cast or spica cast can often correct the condition without surgery. If the initial approach is unsuccessful for children who have not yet started to walk, surgical placement of the hip into the socket may be necessary. After a child starts walking, treatment usually requires surgery. A procedure called an open reduction involves opening up the hip socket. Tissue that prevents the hip from being in position is removed and the hip is carefully placed into the socket.
In hip dysplasia cases that require more extensive repair, the surgeon may perform an osteotomy, a surgical procedure in which the femur (the ball side of the hip joint) or the pelvis (the socket side of the hip joint) is cut and realigned so it can grow into a normal position. For six to twelve weeks after the surgery, the child wears a cast and is not allowed to walk. After the tissues heal with the hip in the new position, the child resumes walking. Follow-up X-rays, taken until the patient reaches young adulthood, ensure that the hip continues to develop in the correct place.
Treatment options include:
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Children's Memorial Hermann Hospital
Houston, TX 77030
Phone: (713) 486-4880
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