Developmental dysplasia of the hip
Developmental dysplasia of the hip (DDH) is gradually replacing the old term 'congenital dislocation of the hip' (CDH). It affects around 1-3% of newborns.
Risk factors
DDH is slightly more common in the left hip. Around 20% of cases are bilateral.
Clinical examination is made using the Barlow and Ortolani tests:
Ultrasound is used to confirm the diagnosis if clinically suspected
Management
Risk factors
- female sex: 6 times greater risk
- breech presentation
- positive family history
- firstborn children
- oligohydramnios
- birth weight > 5 kg
- congenital calcaneovalgus foot deformity
DDH is slightly more common in the left hip. Around 20% of cases are bilateral.
Clinical examination is made using the Barlow and Ortolani tests:
- Barlow test: attempts to dislocate an articulated femoral head
- Ortolani test: attempts to relocate a dislocated femoral head
Ultrasound is used to confirm the diagnosis if clinically suspected
Management
- most unstable hips will spontaneously stabilise by 3-6 weeks of age
- Pavlik harness (flexion-abduction orthosis) in children younger than 4-5 months
- older children may require surgery