The spica is generally kept on for 6 weeks and then replaced with a new cast in the operating room. A procedure is then done in the operating room to get the hip in the proper position and the child is then placed into a spica cast. In some children the hip does not immediately normalize even with a Pavlik harness. The baby’s development is not affected by using the harness. Your pediatric orthopaedist will tell you if the Pavlik can be taken off for bathing. The Pavlik harness is usually worn for up to 3 months, and is surprisingly soft and comfortable. It is designed to keep the legs in the proper position for the hip joint with the ball snugly in the socket, so that the socket develops normally. If DDH is detected soon after birth, the newborn will be placed in a Pavlik harness, a simple device that is strapped around the child’s legs and shoulders. All methods are designed to position the hip together more appropriately and enhance the stability of the joint in the future There are a variety of treatments available for DDH, and the most important determinant in selection of the appropriate treatment is age of the child. This instability may cause osteoarthritis in the joint, leading to a painful limp at a relatively young age. If untreated, the joint may become dislocated, in which the ball sits completely outside of the socket. How is developmental dysplasia of the hip treated? There are usually no major symptoms of DDH, because it is often detected in infants soon after birth and treated without complications, but if an older child starts to toe walk on one side or limp then they should be checked for a hip problem. If there continues to be a concern such as a difference in the length of the two legs, the skin folds on the back of the thigh are uneven from side to side or difficulty moving the leg away from the body on one side, then the baby will be referred to a pediatric orthopaedist and will get an ultrasound of the hips done. If there is concern at birth then the baby is usually checked again 2 weeks later with a physical exam. The baby’s hips are checked by the pediatrician at birth and during all well child visits up to about 6 months of age and sometimes longer. How is developmental dysplasia of the hip diagnosed? Risk factors include being female, the first born, breech presentation at birth and a family history of hip dysplasia. The ligaments of the hip joint may be too loose or stretched and as a result the hip socket does not develop as deeply as is needed for a normal hip. It generally occurs while the child is still a developing fetus, but can occur, more rarely, in early childhood as well. What causes developmental dysplasia of the hip? A hip dislocation happens when the ball (or head of the thigh bone) of the hip joint slips out of the socket (the pelvis). What is developmental dysplasia of the hip?ĭevelopmental dysplasia of the hip (DDH) is a condition in children in which the bones of the hip joint do not form or grow together properly.
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