Developmental Dysplasia of the Hip

Question 1

What is developmental dysplasia of the hip?

Answer 1

Congenital dislocation of the hip

Question 2

What is DDH due to?

Answer 2

Structural abnormality in the hips caused by abnormal development of the fetal bones during pregnancy.

Question 3

How does DDH present?

Answer 3

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

Question 4

What are the 2 main clinical examinations for DDH?

Answer 4

Barlow’s test

Ortolani’s test

Question 5

What is Barlow’s test?

Answer 5

Attempt to dislocate the femur

Question 6

What is Ortolani’s test?

Answer 6

Attempt to relocate dislocated femur

Question 7

What would you find on clinical examination of someone with DDH?

Answer 7

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

Question 8

What are the main Risk factors for DDH?

Answer 8

• Breech presentation
• Oligohydramnios
• High birth weight more than
• First born child

Question 9

What imaging can you do for the diagnosis of DDH?

Answer 9

Ultrasound

Question 10

What would you do if the imaging for DDH was negative at birth?

Answer 10

Repeat ultrasound at 6 weeks

Question 11

What imaging would you use if the child was over 4.5 months?

Answer 11

X-ray

Question 12

What is the management of DDH in children under 6 months?

Answer 12

Pavlik harness

Question 13

What is the management of children over 6 months with DDH?

Answer 13

Surgery