Developmental Dysplasia of the Hip

Question 1

What is developmental dysplasia of the hip?

Answer 1

Congenital dislocation of the hip

Question 2

How does DDH present?

Answer 2

• Recurrent subluxation/dislocation
• Abnormal gait
• Different leg lengths

Question 3

What are the 2 clinical diagnostic tests for DDH?

Answer 3

• Barlow test

* Ortolani test

Question 4

What is Barlow’s test?

Answer 4

Attempt to dislocate the femur

Question 5

What is Ortolani’s test?

Answer 5

Attempt to relocate dislocated femur

Question 6

What other signs will you see on clinical examination of DDH?

Answer 6

• Restricted abduction of the hip
• Asymmetrical leg length
• Asymmetrical level of knees and hips when bilaterally flexed

Question 7

What are risk factors of DDH?

Answer 7

• Female
• First born child
• Breech presentation
• Oligohydramnios

Question 8

What is the main investigation for DDH?

Answer 8

Ultrasound

Question 9

What would you do if the tests for DDH are negative at birth?

Answer 9

Repeat ultrasound at 6 weeks

Question 10

What is the investigation of the child is over 4.5 months?

Answer 10

X-ray

Question 11

What is the management of DDH if younger than 6 months?

Answer 11

Pavlik Harness

Question 12

What is the management if older than 6n months?

Answer 12

Surgery

Question 13

What can happen to the majority of unstable hips in the first 3-6 weeks?

Answer 13

They spontaneously stabilise