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Developmental Dysplasia Of The Hip
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Developmental dysplasia of the hip is a common disorder in which the femoral head is displaced out of the acetabulum due to an abnormal formation of the hip joint. The disease ranges from mild dysplasia of acetabulum to dislocation of the hip.
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- Hip clicks
- Asymmetry of thigh skin fold
- Restricted hip motion, especially when the legs are moved away from the midline
- The affected limb looks shorter than the normal side does due to the dislocation
- Limping if the children begin to walk
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The cause
is unknown, but multiple factors may play a role. High risk
factors include:
- Genetic factors -- family history of hip dysplasia
- Female sex
- First born babies
- Breech deliveries
- It often occurs with clubfoot or congenital torticollis
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- Physical examination
- A hip X-Ray is helpful for children over 3 months of age
- Ultrasonography
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The
treatment varies according to the age of the patients and
the degree of dysplasia. The goal of the treatment is to
place the femoral head into the acetabulum and maintain the
position for the normal development of the hip
structures.
- In the first 6 months of life, a Pavlik harness is used to maintain the normal position of the femoral head. If this does not work, the femoral head is placed into a normal position under general anesthesia (closed reduction).
- When the child reaches 6 months of age, a closed reduction is used with a hip spica cast.
- In a child older then 1 or 2 years of age, if the closed reduction is not successful, surgery will need to occur.
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Early diagnosis and treatment are important for a favorable outcome. If left untreated, complications such as limping and hip arthritis will occur when the child begins to walk.
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