In Developmental dysplasia of the hip (DDH), the “ball and socket” joint of the hip does not develop appropriately in babies and young children. Therefore, it is also known as congenital hip dislocation or hip dysplasia.
The hip joint connects the femur (thigh bone) to the pelvis. The top portion of the femur, or femoral head, is rounded like a ball and lies within the cup- shaped hip socket.
DDH refers to the condition in which the hip is too shallow, and the femoral head is not held firmly in position making the hip joint loose. The femur can even come out of the socket, or dislocate, in severe cases.
More Often in Females
While DDH can impact one or both hips, it occurs more commonly in the left hip. On top of this, it develops more frequently in girls and firstborn children. Nearly one or two in every 1,000 infants have DDH that requires treatment.
If left untreated, DDH may cause the following issues later in life:
- Limp development
- Hip pain, specifically in adolescence
- Stiff and painful joints (Osteoarthritis)
The early diagnosis and treatment of this condition enable most children to develop in a normal manner and have a full range of motion in their hip.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, CA, and surrounding communities.
Diagnosing DDH
The infant’s hip will be evaluated as a routine part of the newborn physical exam within 72 hours of giving birth. When the baby is between six and eight weeks old, another hip exam will be performed.
Pavlik Harness
Infants who are diagnosed with DDH early on are typically treated with a fabric splint known as a “Pavlik harness.” This harness secures the baby’s hips as well as allows them to develop in a normal manner.
The baby will need to wear the harness at all times for several weeks. Only health professionals should remove this harness. During follow-up appointments, the medical professional may adjust the harness and discuss the baby’s progress with the parent(s).
Surgery
If the baby is older than six months, or if the Pavlik harness has been ineffective, they may require surgical intervention. Reduction is the most common surgical technique to treat this condition, and it involves the placement of the ball of the femur back inside the hip socket.
This surgeon will perform reduction with the patient under general anesthesia. It may be done in the following ways:
- Closed Reduction: The surgeon will place the ball in the socket without placing any significant incisions (cuts).
- Open Reduction: In this procedure, the surgeon places an incision in the groin to enable them to place the ball in the socket.
The child will require a hip cast for a minimum of six weeks following surgery. The doctor will perform a hip examination with the child under general anesthesia again to ensure that it is healing properly.
A Possibility
Following this examination, the patient will likely need a cast for at least another six weeks to help the hip to stabilize completely. In some cases, the child may need osteotomy (bone surgery) as well during an open reduction, or later on, to correct any deformities of the bones.
Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:
Century City / Los Angeles: 310.595.1030
Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.
Also visit http://www.drgorthopedics.com/
