Developmental Dislocation (Dysplasia) of the Hip (DDH)
Developmental dysplasia of the hip (DDH) is a common disorder that is seen in infants and young children. It may be present at birth or may occur during the first year of life of an infant. As the name suggests, it occurs due to improper development of the hip joint either while the fetus is in the uterus or during the growth phase in the first year of life.
In a normal hip, the head of the femur (thigh bone) fits well into the socket (acetabulum) whereas in hip dysplasia, the socket and femoral head are not congruent because of their abnormal development. The exact cause of DDH is not clear. However, there are factors that may contribute to the development of DDH, which may include:
- Abnormal position of the femoral head
- Too shallow or sloping acetabulum rather than normal cup shape
- Laxity or looseness of the ligaments around the joint
- Breech position of the fetus leading to abnormal stress on the hip joint
Swaddling or wrapping of the infant with both legs tied together and extended out straight
DDH can be mild or severe and can affect one or both hips. It is more common in girls and usually affects the left hip. DDH does not cause any pain and so the condition may not be noticed until the child starts to walk. A child with DDH may walk with a limp (if one hip joint is affected) or waddle (if both hip joints are affected). If both hips are dislocated, the child’s abnormal walk (gait) is difficult to detect.
Appropriate screening should be performed for all newborns and infants for the early detection of DDH. This is especially important if the baby is born by breech or has a family history of DDH. Usually, Ortolani’s maneuver or Barlow’s test are used to detect any hip instability in infants. For infants older than three months, an additional Galeazzi’s test may be performed. In this test, any difference in knee height is examined while the child is made to lie on their back with the legs folded at the knee. If any one of these tests is positive, your child will be closely observed or treated with a brace. During hip examination, the doctor may also look for the difference in range of motion of the hip, presence of uneven skin folds around the thigh and difference in leg length from side to side. In infants less than 6 months, an ultrasound may be advised to confirm the diagnosis.
The treatment for DDH depends on both the age of the child and severity of the condition. The aim of treatment is to keep the femoral head in good contact with the acetabulum so that the hip can develop normally. If detected in the first six weeks, double and triple diapering may be required. If the problem continues to exist, use of a pavlik harness to keep the hip in flexion and abduction may be advised. Only when conventional treatment is not effective, surgery to put the hip back into place may be advised.
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Houston Hip Specialists
Advanced Orthopedics and sports medicine has numerous Board Certified/Eligible physicians who are thoroughly educated in the latest treatment techniques both surgical and conservative. They are well versed in advances in hip treatments including arthroscopic labral repairs, minimally invasive anterior hip replacement, total and partial hip replacements.
Drs Elbaz and Brooks now perform Platelet-Rich Plasma (PRP) injections for the treatment piriformis syndrome, greater trochanter bursitis, ischial bursitis, sacroiliac joint pain and hamstring tendonitis/tears. PRP stimulates a more rapid healing of tendon, ligament, muscle and bone.
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Each procedure done by Dr. Patel has been an improvement. Very pleased.
Dr. Patel has been a great Doctor for me. When I was referred to after discussion we decided to do injections in my back. The first two did not work so did two more in a different section of my back. These injections worked great. I’m now able to sleep at night and the numbness in my foot is almost gone. The tingling in my foot & leg is gone and I am very happy about that. I am extremely happy that Dr. Patel is my Doctor. She has been a good listener when I tell her where I hurt and talks to me about what she feels should be done. The final decision is always mine.
On Nov. 22, 2017, I had a spinal injection in my lower back and it was an instant miracle in my life! For the first time in 4 intolerable months of pain, I was finally pain free, and I am now getting a second chance to live again! I am so grateful to Dr. Patel for my new life, and to God for guiding me to her! Thank you so very much Dr. Patel – you are God’s gift to me, thank you for being so awesome at what you do.
Dr. Patel is one of the best Doctors I have ever had. She is pretty good at her job. She makes it plain and simple. She is also very thoughtful. I was very glad to have met her. In other words she is pretty good.
The surgery done by Dr. S. Patel (Actually injections) & the mild medications she has prescribed has surely made my lower back -hip-leg less painful. I have complete confidence in her medical judgement & advice. She will administer second injection in June.
Dr. Patel is a very good Pain Management Doctor. She is one of my favorite doctors.
Dr. Patel has been great at my pain relief. She doesn’t force me to take any meds I don’t want, or injections. She will give me the injection I want when I need it. Great friendly Doctor.
Thank you for the opportunity to express how pleased I am with the excellent care of Stacy A. Bacon, M.D. I have confidence in her ability to care for me as she successfully partially replaced a broken hip 10 years ago, 2007. I also want to compliment Cheryl who set up the appointment. She represents Advanced Orthopaedics & Sports Medicine very well.
It’s been over 8 years since Dr. Bacon replaced by right ankle. I still can’t thank her enough for the years of pain free walking I have done since! And I’m still going strong! I had numerous breaks in my ankle due an auto accident, repaired/set by a different doctor, after multiple surgery’s, I was still limping, in great pain every day. Then I found Dr. Bacon, now, no more pain, NONE, and no more limping after this ankle replacement. I rave about her constantly and would recommend her to anyone who has a foot or ankle issue
I had been in so much pain with my back for years. It got so bad that I knew I had to do something. I went to Dr Mohr for help. I was so afraid to have spine surgery as I had heard so many horror stories. He and his staff were very informative. I was amazed at the new technology in spinal surgery. December 8, 2016 I had rods and pins put in my back. I am so happy I did now. I am healing really fast and the pain is going away as my body heals. Thank you Dr Mohr for you expertise and sensitive nature. You were understanding about my fear and helped assure me so I could receive the help I needed. You are an excellent Doctor.