developmental dysplasia of hip

DDH:

  • pt: female, breech position, family hx
  • cause: abnormal dev, femoral head displaced, excessively tight swaddling
  • sx:
    • asymmetrical inguinal folds. Fold extend beyond anal aperture
    • leg length discrepancy on Galeazzi test
  • dx:
    • barlow, ortolani maneuvers
    • US < 4 months
    • Xray > 4 months
  • rx:
    • when diagnosed within first 6 months of life, treat with Pavlik harness for 3 months, but needs monitor with surgery
    • referral to surgery after diagnosis
  • prognosis:
    • Most infants who are treated early have no long-term sequelae. However, residual dysplasia can still occur, so patients require close follow-up until skeletal maturity is reached. Residual dysplasia potentially warrants surgery and can lead to osteoarthritis, but this risk is low for infants treated for DDH in infancy