Developmental dysplasia of the hip (or DDH) is a condition that can be both congenital (born with it) or develop during infancy. It involves poor alignment and possible dislocation in a or both hip joints and normally requires treatment. This post will go through some of the terms you may hear when your child is diagnosed, some good resources (well really the only one you need), and common orthoses used in treating DDH.

 

First things first: Go easy on yourself!

Quite honestly one of my biggest concerns when treating a DDH patient is how the parents are coping.  I often hear “is there something I could have done?” or “did I do something wrong?” There are many reasons as to why DDH can develop – most of the time it is there because it just is and that’s mother nature for you. DDH is more common in girls (because of the way a female pelvis is shaped), first borns and breach babies.

There are some cultures with swaddling and babywearing techniques that force a baby’s hips into prolonged extension which then can develop into DDH. Interestingly, there are some cultures who babywear and incorporate healthy hip alignment ( hip flexion and abduction) with some amazing epidemiological trends showing little DDH. If you’re unsure about your swaddling technique or babycarrier, I recommend you ask your baby’s medical practitioner or allied health professional.

 

Don’t over google!

If you are here, chances are you have over-googled. STOP! Don’t go any further until you have had a discussion with you physician, orthopaedic surgeon, orthotist or physiotherapist.

I do recommend the following site as it has everything you need to know. The International Hip Dysplasia Institute:  http://hipdysplasia.org/

 

Things you may hear

When you attend medical appointments you may come across a few of the following DDH terms:

  • DDH: Developmental dysplasia of the hip
  • CDH: Congenital dysplasia of the hip (this is an outdated term as it implies a baby can only be born with the condition rather than have it develop over time)
  • Hip flexion: when the thigh flexes towards the torso
  • Hip extension: when the thigh moves away form the torso (leg down)
  • Hip adduction: when the legs are brought together
  • Hip abduction: when the legs are brought outwards
  • Femur: thigh bone
  • Acetabulum: the covering of the “ball” of the hip joint
  • Dysplasia: abnormal development
  • Dislocated: when complete misalignment of the hip joint occurs – the ball is no longer inside the socket
Treatment
Treatment for DDH varies on the severity of the dysplasia. In mild cases monitoring and mindful positioning (eg: promoting hip abduction (legs out) when changing nappies, breastfeeding, etc) is sufficient.  Severe DDH may require surgery or hip spicas (plaster casts that remain on for several weeks). Most DDH diagnoses require treatment using an orthosis that places the baby’s hips in the optimal alignment (hip flexion and abduction). The role of orthoses and hip spicas is to maintain the optimal alignment whilst the baby grows.
What orthoses are used?
Depending on your baby’s age and the orthoses available in your health service, your baby may be prescribed one of the following orthoses.
Rhino Brace/ Hip abduction brace
This brace is made from a high temperature thermoplastic, soft foam lining and fastens with Velcro.
Correctio brace
A correctio brace is a piece of aluminium which can be reshaped as the baby grows, covered in a thick layer of  foam and latex. It suspends using leather straps that are fed through D rings at the front.
Pavlik harness
The Pavlik harness is probably the most common hip orthosis. It is made from felt, webbing and Velcro.

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