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Developmental Dysplasia of the Hip (DDH): Overview

What is developmental dysplasia of the hip?

Developmental dysplasia of the hip, also referred to as DDH, is a condition in which the hip joint develops abnormally.  The hip joint is made up of the thigh bone (the femur) and the pelvic bone. The upper end of the femur is shaped into a ball (femoral head) that fits into a socket (the acetabulum).  

In a normally developed hip, the round femoral head will sit inside of the socket.  In a patient with DDH, the bone of the hip socket is either too shallow, misshapen, or not deep enough to completely cover and support the femoral head.

Most commonly, there are four variations of hip and ball placement that can lead to DDH in a child. They are:
•    A hip that has a shallow socket.
•    A hip where the femoral head (the ball) is loose in the socket. This is called subluxatable.
•    A hip that is dislocatable. This happens when the femoral head (the ball) can come out of the socket when stress is applied.
•    A hip that is currently dislocated (the femoral head is already out of socket).

The severity of DDH and the age of your child will determine the course of treatment.  The goal of treatment is to manipulate the femoral head (ball) to fit deep inside the socket to allow the hip to properly develop.

What causes developmental dysplasia of the hip?

The actual causes of DDH are still unknown; however, it seems that hip dysplasia is a developmental problem. It can occur before birth, after birth and less often during infancy.

Who gets developmental dysplasia of the hip?

There are several recognized risk factors for hip dysplasia:
•    A family history of hip problems
•    Being the first-born child
•    Female (versus male) gender
•    Babies who are born in the breech position (head up and feet down)

Helpful resources for developmental dysplasia of the hip:

•    The Hip Program at Children’s Hospital Colorado
•    Pediatric Orthopedic Society of North America
•    International Hip Dysplasia Institute

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