developmental dysplasia of hip

• related: Pediatric

DDH:

• pt: female, breech position, family hx
• cause: abnormal dev, femoral head displaced, excessively tight swaddling
• sx:
  • asymmetrical inguinal folds. Fold extend beyond anal aperture
  • leg length discrepancy on Galeazzi test
• dx:
  • barlow, ortolani maneuvers
  • US < 4 months
  • Xray > 4 months
• rx:
  • when diagnosed within first 6 months of life, treat with Pavlik harness for 3 months, but needs monitor with surgery
  • referral to surgery after diagnosis
• prognosis:
  • Most infants who are treated early have no long-term sequelae. However, residual dysplasia can still occur, so patients require close follow-up until skeletal maturity is reached. Residual dysplasia potentially warrants surgery and can lead to osteoarthritis, but this risk is low for infants treated for DDH in infancy