Developmental (Congenital)

Dysplasia of the Hip.

 Definition
• It is a lost of the relationships
between hip joint components.
• Occurs in neonatal period.
• 1 of each 6 newborn have hip
instability.
• Incidence of true hip dislocation
is 2-5/1000 live births.
 Clasification
Dysplasia
Typical
Subluxation
Developmental
(Congenital) Dislocation
Dysplasia of the Hip
Teratologic
 Etiology & Risk Factors
Etiology -> idiopathic (unknown)
• Risk factor :
– Genetic -> ligamentous weakness
– Environment
• Intrauterine
– Insistence: twins, oligohydramnios Pressure can result in
fetal femoral head which is still not fixed properly
separated from the acetabulum.
– Hormone: RelaxinRelaksin is a hormone that appears
when parturition to relax the pelvic bones
– Parturition
• Errors in parturition help
• Babies with butt interpretation
– Postpartum
• Swaddle habits. Swaddling so tightly that the child's
legs which are supposed to be flexed into extensions
make the possibility of DDH high.
 Diagnosis
• History -> age, risk factors, onset.
• Clinical maneuvers
– Barlow test
– Ortolani test
– Galeazzi
– Limitation of hip abduction
– Peter-Baden sign (Asymetry
of tight folds)
– Compared transmission of the sound
tests
 Diagnosis.

• Ultrasonographic diagnosis
It is of first election in lesser of 4
months of age
It is used Graf’s scale with dynamic
and static test
 Diagnosis.

• Radiologic diagnosis
It is not useful if the head femoral is
not evident.
Anteroposterior and AP in abduction.
Hilgenreiner line, angle of Winberg,
Shenton line.
 Treatment.

Divided by age. The younger the child

is, the easier it is to manage.
• Pavlik harness
• Fredjka splint
• Double and triple diapers
are controversial
 Patogenic Period.
Complications.

• Avascular necrosis of the femoral head

• Redislocation
• Residual subluxation
• Acetabular dysplasia
• Postoperative complications (wound
infections)
 Follow Up.
• Treatment of complications is
surgical and the patients should be
treated by expert.
• Patients should be checked monthly,
then each six months, until adult
life.
 Follow Up.

• Excercise of hips and knees

• Reducation of the gait