What are the best treatments for developmental hip dysplasia (DDH)?

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HIP DYSPLASIA IN BABIES
By Travcure Medical Tourism
www.travcure.com
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INTRODUCTION
What is Hip Dysplasia? The term 'Hip Dysplasia'
encompasses a variety of hip joint disorders. The
hip-joint is a 'ball and socket' joint where the
ball at the upper end of the thighbone fits
firmly in the socket which is part of the large
pelvis bone. When the ball does not fit properly
in the socket, that condition is called as 'Hip
Dysplasia'. What is Developmental Dysplasia of
Hip? Developmental Dysplasia of Hip (DDH)
affects the hip joint in infants young
children. The condition can be congenital or
develop later during birth, after birth or during
early childhood. DDH occurs in about 1 to 3 out
of every 100 babies.
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CAUSES

• CAUSES OF CONGENITAL HIP DYSPLASIA
• Family History
• Breech Position
• First Pregnancy
• Large Babies
• Reduced Amniotic Fluid During Pregnancy
• Other disorders like Cerebral Palsy or Spine
  Problems
• Gender
• CAUSES OF ACQUIRED HIP DYSPLASIA
• Improper Swaddling Techniques
• Restrictive Baby Car Seats
• Unsafe Baby Carriers/Slings

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SIGNS SYMPTOMS

• Asymmetry One leg appears shorter than the other
  or presence of uneven skin creases
• Hip Click The sound of hips clicking or popping
  can be an indicator of hip dysplasia
• Limited Range of Motion Babies with Hip
  Dysplasia have trouble spreading their legs
  completely which may cause difficulties in
  diapering.
• Pain Pain in the hip joint is usually not
  present in babies but is a common symptom of
  adult hip dysplasia.
• Swayback If the child limps while walking, it is
  due to one limb becoming shorter than the other.
  This is a clear sign of hip dysplasia.

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DIAGNOSIS

• Hip instability during birth is commonplace as
  the tissues are soft and lax. Usually, the
  tissues tighten within 2 months and the
  instability disappears. If hip instability
  persists for 4-6 months after birth, the
  following diagnostic tests can be carried out to
  detect hip dysplasia
• Physical Examination
• Ultrasound Imaging (under 4 months)
• X-Ray (for over 4-6 months of age)
• Magnetic Resonance Arthrogram (MRA) scan
• Computed Tomography (CT) Scan

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TREATMENTS

• The goal of DDH treatment is to correct the hip
  joint abnormality and restore proper movement.
  Commonly used treatments include
• Pavlik Harness This harness is used to hold the
  infants hips in correct position. It is usually
  the first treatment after DDH is detected in
  babies younger than 6 months. The harness keeps
  the babies leg bent turned outwards and allows
  restricted movement thereby helping the hip to
  get stabilized.

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TREATMENTS

• Closed Reduction Spica Cast If harness
  technique is not effective, pediatric
  orthopedists anaesthesize the child and positions
  his/her hip correctly. A special cast or plaster
  is then applied to keep the hip joint in the
  correct position. This technique is usually used
  for kids over 6 months of age the plaster is
  kept on for atleast 12 weeks. MRI or CT scan is
  done to ensure that the hip position is correct.
• Open Reduction If DDH is detected late and the
  babies have already grown up, a small operation
  is carried out to treat hip dysplasia. In this
  operation, the tendons surrounding the joint are
  loosened and anything that possibly restricts the
  movement of the hip is removed. Once the hip is
  able to move freely, the joint is then
  strengthened.

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TREATMENTS

• Surgery If all the above techniques fail and DDH
  remains unresolved even after 18 months of age,
  more complicated surgeries are required. Surgical
  techniques include hip replacement or total hip
  arthroplasty. Hip resurfacing can effectively
  treat adult hip dysplasia. If the type is hip
  dislocation, then hip replacement is usually
  recommended.
• Early treatment of DDH ensures higher success
  rate and avoid long-term complications.

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