Paediatrics

Developmental Dysplasia of the Hip

Developmental dysplasia of the hip (DDH) is a spectrum from a shallow acetabulum through instability and subluxation to dislocation; early recognition and a stable, concentric hip position allow the socket and femoral head to develop together.

Definition

Developmental dysplasia of the hip is a spectrum of abnormal development and instability of the hip, ranging from acetabular dysplasia through subluxation to dislocation. The condition may be present at birth or evolve during infancy.

First principles

The socket and femoral head mould one another

The infant acetabulum and femoral head are predominantly cartilaginous. A centred femoral head stimulates a deep, congruent socket; persistent subluxation or dislocation prevents this and allows dysplasia to worsen. Treatment therefore aims to identify an unstable or dysplastic hip and maintain safe reduction during growth.

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