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Pediatric Hip Dysplasia Care Pune
Get expert developmental hip dysplasia treatment in Pune with pediatric surgeons providing early diagnosis, stabilization, and corrective surgery.
Overview
Developmental dysplasia of the hip (DDH) is a common pediatric condition where the hip joint fails to develop properly. In this condition, the ball-shaped top of the thigh bone (femur) and the cup-shaped hip socket (acetabulum) don’t fit together correctly. This misalignment can range from a slightly loose joint to a completely dislocated hip where the ball sits entirely outside the socket.
The key to successful outcomes lies in prompt detection and appropriate intervention. Without proper treatment, children may experience long-term complications including chronic pain, difficulty walking, and early arthritis. However, with timely care, most children go on to live completely normal, active lives.
Symptoms
Developmental dysplasia of the hip symptoms can be subtle, especially in newborns and infants. Many babies with DDH appear completely normal and don’t experience pain initially. However, parents and caregivers should watch for these warning signs:
In newborns and infants:
- Uneven skin folds on the thighs or buttocks
- Limited hip flexibility when changing diapers
- One leg appearing shorter than the other
- Clicking or popping sounds when moving the hip
- Difficulty spreading the legs during diaper changes
In toddlers and older children:
- Delayed walking or reluctance to bear weight
- Limping or waddling walk
- Toe walking on the affected side
- Back pain from compensating for hip problems
- Fatigue during physical activities
Causes
Developmental dysplasia of the hip results from a combination of factors that affect normal hip development during pregnancy and early infancy. The condition occurs when the hip joint doesn’t form properly, leading to instability or dislocation.
Several factors contribute to DDH development:
- Genetic factors play a significant role, with the condition running in families. If a parent or sibling has DDH, the risk increases substantially.
- Mechanical influences during pregnancy can affect hip development. When a baby is positioned in the womb with limited space for movement, abnormal pressure on the developing hip joint can occur.
- Hormonal factors also contribute, as maternal hormones during pregnancy can cause increased looseness in the baby’s ligaments, making the hip joint more susceptible to instability.
- Environmental factors after birth, such as tight swaddling with legs straight and pressed together, can worsen existing hip instability or contribute to its development.
Risk Factors
Understanding the risk factors for developmental dysplasia of the hip (DDH) helps parents and healthcare providers identify babies who may need closer monitoring. Several factors can increase the likelihood of developing DDH:
- Gender is a significant factor, with girls being 4-5 times more likely to develop DDH than boys. This increased risk is partly due to greater sensitivity to maternal hormones.
- Birth position matters significantly. Babies born in breech position (buttocks or feet first) have a much higher risk due to the hip positioning during delivery.
- Family history is crucial, as DDH has a strong genetic component. Children with affected parents or siblings face increased risk.
- Birth order influences risk, with firstborn children more likely to develop DDH due to tighter uterine muscles that can restrict fetal movement.
- Pregnancy conditions such as low amniotic fluid (oligohydramnios) can limit fetal movement and increase DDH risk.
- Associated conditions including foot deformities, neck muscle tightness (torticollis), or other musculoskeletal abnormalities often occur alongside DDH.
Diagnosis
Developmental dysplasia of the hip diagnosis relies on a combination of physical examination and imaging studies. Early and accurate diagnosis is crucial for optimal treatment outcomes.
Physical examination forms the foundation of DDH diagnosis. Pediatricians routinely screen newborns using specific maneuvers:
- Ortolani test: Attempts to relocate a dislocated hip back into the socket
- Barlow test: Tries to dislocate an unstable hip from the socket
- Assessment of hip flexibility and range of motion
- Examination of leg lengths and skin fold symmetry
Imaging studies provide detailed information about hip structure:
Ultrasound is the preferred method for babies under 6 months because their bones are still cartilaginous and don’t show well on X-rays. This painless test provides real-time images of the hip joint.
X-rays become useful after 6 months when bones have developed enough to be visible. These images help evaluate bone alignment and joint development.
Clinical monitoring continues throughout childhood, with regular check-ups to assess hip development and function, especially in high-risk children.
Types
DDH exists along a spectrum of severity, with different types requiring varying approaches to treatment:
- Subluxatable hip occurs when the femoral head is not fully seated in the socket but can be partially displaced with manipulation.
- Dislocatable hip describes a condition where the femoral head can be moved in and out of the socket during examination.
- Dislocated hip represents the most severe form, where the femoral head sits completely outside the socket at rest.
- Acetabular dysplasia involves a shallow hip socket while the ball remains in place, potentially leading to instability over time.
Treatment
- Developmental dysplasia of the hip treatment varies significantly based on the child’s age at diagnosis and the severity of the condition. Early intervention generally leads to better outcomes with less invasive treatments.
- For newborns to 6 months: The Pavlik harness is the gold standard treatment for young infants. This soft brace holds the hips in an optimal position that promotes normal development. The harness is worn continuously for 6-12 weeks, with regular monitoring to ensure proper positioning and hip development.
- For infants 6 months to 2 years: Closed reduction may be necessary if the Pavlik harness fails or if diagnosis occurs later. Under anesthesia, the orthopedic surgeon gently manipulates the hip back into proper position, followed by a spica cast to maintain alignment for 3-6 months.
- Open reduction becomes necessary when closed reduction fails. This surgical procedure involves making an incision to directly place the hip in the correct position, often combined with tightening of the hip capsule.
- For older children: Surgical intervention typically involves more complex procedures such as osteotomies (bone cuts) to reshape the hip socket or thigh bone, improving joint stability and function.
- Physical therapy supports all treatment approaches by maintaining muscle strength, flexibility, and promoting normal movement patterns.
Rehabilitation
Rehabilitation plays a crucial role in DDH recovery, helping children achieve optimal function and preventing complications. The rehabilitation process is tailored to each child’s age, treatment stage, and individual needs.
Goals of rehabilitation include:
- Restoring normal hip mobility and flexibility
- Strengthening muscles around the hip joint
- Promoting proper walking patterns
- Preventing muscle contractures and joint stiffness
Complications
Untreated or inadequately managed DDH can lead to significant long-term complications that affect quality of life and mobility:
- Early-onset arthritis is the most serious long-term complication, occurring when abnormal hip mechanics cause premature joint wear and tear.
- Chronic hip pain may develop as the child grows, particularly during physical activity or after prolonged sitting.
- Abnormal gait patterns can persist, leading to limping, waddling, or other compensatory walking patterns that affect the entire musculoskeletal system.
- Leg length discrepancy may result from abnormal hip development, potentially requiring shoe lifts or additional surgical procedures.
- Reduced hip mobility can limit participation in sports and physical activities, affecting overall fitness and social development.
- Avascular necrosis, though rare, represents a serious complication where blood supply to the femoral head is disrupted, leading to bone death and requiring complex treatment.
Prevention
While not all cases of DDH can be prevented, several measures can reduce risk and promote early detection:
- Routine newborn screening ensures early identification of hip abnormalities when treatment is most effective.
- Safe swaddling practices are essential. Parents should use hip-friendly swaddling techniques that allow the hips and legs to move freely in their natural “frog-leg” position.
- Awareness in high-risk families promotes vigilance for symptoms in children with known risk factors such as breech presentation or family history.
- Regular pediatric check-ups allow for ongoing monitoring of hip development, especially during the first year of life.
- Prenatal care helps identify risk factors such as breech positioning or low amniotic fluid that may increase DDH likelihood.
Living With Developmental Dysplasia of the Hip
A DDH diagnosis can feel overwhelming for families, but understanding the condition and treatment options helps parents navigate the journey successfully. Most children treated appropriately go on to lead completely normal, active lives.
- During treatment, families must maintain regular follow-up appointments, adhere to harness or cast care instructions, and monitor for any concerning symptoms. Support from healthcare teams, including orthopedic surgeons, physical therapists, and specialized nurses, provides comprehensive care.
- Long-term outlook is generally excellent with proper treatment. Most children achieve normal hip function and can participate fully in sports, dancing, and other physical activities. However, some may require ongoing monitoring into adulthood to ensure continued hip health.
- Emotional support is important for both children and families. Connecting with support groups, educational resources, and other families who have navigated similar experiences can provide valuable guidance and reassurance.
- Activity modifications may be temporarily necessary during treatment, but most children can return to normal activities once treatment is complete.
Key Takeaways
- Developmental dysplasia of the hip is a treatable condition affecting hip joint development that requires early detection for optimal outcomes
- Early intervention is crucial, with the Pavlik harness being highly effective for infants under 6 months
- Regular screening and awareness of risk factors help identify DDH before complications develop
- Treatment success depends on the child’s age at diagnosis and severity of the condition
- Most children with properly treated DDH achieve normal hip function and lead active lives
- Sancheti Hospital provides comprehensive DDH care with experienced pediatric orthopedic specialists, advanced diagnostic capabilities, and multidisciplinary rehabilitation services to ensure the best possible outcomes for children with hip dysplasia
Meet Our Pediatric Orthopedic Specialists
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
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The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
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Kishore Bhosle
Frequently Asked Questions
Can DDH be detected before birth?
DDH cannot be directly diagnosed before birth, but prenatal ultrasounds may identify risk factors such as breech positioning that increase the likelihood of developing the condition.
Is DDH painful for babies?
Most infants with DDH do not experience pain initially. Pain typically develops later if the condition remains untreated and leads to joint problems or arthritis.
Will my child need surgery for DDH?
Not all children require surgery. Early-detected DDH can often be successfully treated with a Pavlik harness. Surgery is reserved for cases where non-surgical methods fail or when diagnosis occurs later.
How long does treatment take?
Treatment duration varies by method and severity. Pavlik harness treatment typically lasts 6-12 weeks, while surgical cases may require several months of casting followed by rehabilitation.
Can DDH affect both hips?
Yes, DDH can affect one or both hips, though unilateral (one-sided) involvement is more common. Both hips are always evaluated during diagnosis and treatment planning.
