The hips joint is a ball and socket joint. i.e. the femoral head (ball) articulates with the acetabulum (socket). In DDH, the acetabulum is shallow and so the femoral head is either inadequately covered (dysplasia/ subluxation) or completely dislocated
Though the exact cause of DDH is not known, the following risk factors are known to be associated with increased incidence of DDH:
USG Hip In DDH
X-ray in DDH
The treatment plan for your child will be guided by their age and the abnormality to the hip. Newborns with DDH respond well to treatment in a soft brace (called a Pavlik harness) for six to ten weeks. The brace helps the hip develop and grow normally. The Pavlik harness will not cause long-term delay to your baby’s development. Your baby will catch up once the brace is off.
Some baby’s hips do not improve with early treatment, and DDH can be found in older children. X-rays are used to look at your child’s hips after six months of age. If the socket of the pelvis is too shallow and the femoral head is too small, the femoral head may easily move in and out of the socket. A femoral head that stays outside the socket is dislocated. If not found before walking age, a dislocated hip can cause a painless ‘waddling’ walk. As the child grows older, their hip will become stiff and painful (called arthritis).
Surgery may be needed for children older than six months, or children whose hips do not improve after wearing the Pavlik harness. The type of surgery needed will depend on the age of your child and the abnormality to the hip. Your doctor will discuss the type of surgery needed. If surgery is needed, a plaster lower body cast (called a hip Spica) will hold your child’s hip in place. This may be for a few months. The hospital staff will show you how to care for your child. A few children may not improve after treatment. They may require surgery between two to four years of age. All surgery has risks and benefits. Your child’s surgeon will tell you about the risks and benefits before the surgery.