Developmental Dysplasia

Question 1

What is developmental dysplasia?

Answer 1

Formerly known as congenital dislocated hip.

It is a congenital disorder in which there is a shallow acetabulum allowing the dislocation of the femur.

It is a spectrum of disease ranging in severity.

Question 2

How common is developmental dysplasia?

Answer 2

1-3% of newborns

Question 3

What are the risk factors for having developmental dysplasia?

Answer 3

Infant:
FH
Females
Other neuromuscular disease

Antenatal:
More common in first borns 
Increased risk if baby was breeched
Oligohydraminos in utero.
Multiple preganancies
Prematurity

Question 4

What is the screening regimen for developmental dysplasia?

Answer 4

It is assessed in the physical examination using Barlow and Ortalani tests during the:

• Newborn check
• 6-8week check

In some high risk babies there will have a USS

Question 5

How do children with developmental dysplasia present?

Answer 5

Usually picked up on screening.

May present with one leg shorter than the other.
Painless limp.
Walking on tip toes on affected side.

Asymmetrical skin folds only significant if there are other signs also.

Question 6

What is the basic management of developmental dysplasia?

Answer 6

Often corrects itself after 6 weeks, if this is not the case prompt treatment is needed.

Non surgical:
Bracing is first-line treatment in children younger than 6 months.

Surgical:
For children in whom non-operative treatment has failed and/or children diagnosed after 6 months of age.