· Also known as congenital hip dislocation or hip dysplasia.
· A condition in which the “Ball and Socket Joint of hip ” are not developed properly in babies and young children.
· Anatomically, the thigh bone is attached to the pelvis with the help of Hip joint. The head of the Femur (ball shaped round) sits inside the hip Socket ( Cup Shaped).
· When the hip socket is too shallow and it is not able to hold the femoral head tighly at place, the hip joint is loose which in server cases can cause the dislocation of the femoral head.
· One or both hips can be affected
· Left hip is more commonly involved
· More common in first born children and girls
· An early diagnosis and treatment of the problem can enable the most of children for normal development and max range of hip movement.
· If this condition left untreated, it may lead to multiple issues later on , which include:
o Pain in the hip
o Osteoarthritis / painful joints
· When Babies born in the breech position especially in the cases with feet up by the shoulders. DDH Ultrasound screeing is now recommended by the American Academy of Pediatrics for all female breech babies Family history of DDH (parents or siblings)
· Oligohydramnios – low levels of amniotic fluid
For successful treatment of the CDH it is mandatory to understand the natural history of the disease. For abnormal neonatal hips , following are the possible outcomes:
1. May normalize
2. Dysplasia – may stabilize with abnormal development of acetabulam or femoral head
The treatment goals for CDH is
· To produce normal development of acetabulum and femoral head
· To achieve the concentric reduction of hip
· To reduce or avoid the associated complications due to treatment like infection, stiffness and Avascular necrosis of Femoral head
· To minimize and avoid the hardship to parents and the patient either, physical/emotional/financial.
1. Frejka Pillow
2. Pavlik harness
3. Von Rosen Orthosis
4. Ilfled Orthosis
5. Plastazote Hip Abduction Orthosis