Developmental Dysplasia of the Hip

(DDH; Congenital Dysplasia/Dislocation of the Hip [CDH]; Congenital Dysplasia of the Hip; Congenital Dislocation of the Hip; Congenital Subluxability of the Hip; Congenital Hip Dysplasia; Congenital Hip Dislocation; Congenital Hip Subluxability; Dysplasia of the Hip, Developmental)

Definition

The hip is where the thigh bone and pelvis meet. The thigh bone has a ball-shaped top. This ball fits into a cup-shaped area on the pelvis. Developmental dysplasia of the hip (DDH) is a problem with how these bones fit together. The exact problem can vary between children but may include:
  • Ball of the thigh is loose inside the cup of the pelvis—makes the hip unstable
  • Ball moves easily out of the cup—causing a dislocation of the hip
  • Ball and cup do not meet at all
  • The cup is improperly shaped
The Hip Joint
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Causes

The exact cause of DDH is not known. Some factors that may play a role include:
  • How the baby is positioned in the womb
  • Maternal hormones
  • Genetics
Certain carrying or wrapping techniques may also affect the growth of the hip, especially methods that have the child tightly bound in a position with the hips straight out and turned in.

Risk Factors

DDH is more common in females. Other factors that may increase your baby’s chance of developing DDH include:
  • Family history of DDH
  • Breech birth (feet first), especially in females
  • Low levels of amniotic fluid during pregnancy
  • Late delivery—birth after 42 weeks of pregnancy
  • Birthweight greater than 8 pounds 13 ounces (4 kg)

Symptoms

DDH can make the hip unstable and loose. Symptoms may depend on the age of your child. They may include:
  • Uneven folds in the area of the thigh or hip—may be visible in newborns
  • Poor mobility and flexibility when beginning to crawl—around 9 months
  • One leg shorter than the other—10-11 months
  • Limping, lurching, walking on toes, or other unevenness in walk at about 1 year
DDH more commonly affects the left hip. Sometimes both hip joints are affected. The condition may be detected when the baby is born.

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