Signs and Symptoms of Developmental Dysplasia of the Hip (DDH) in Infants
Mar 04, 2022
Source: Cainiu Health
Dr. Ma Yan
Introduction
In children, hip dislocation is classified as congenital hip dislocation, primarily caused by developmental dysplasia of the hip. Clinical manifestations include:
1. **Joint mobility impairment**: The affected limb is typically held in a flexed position, with reduced mobility compared to the unaffected side; pushing or stepping force is predominantly exerted by the contralateral limb. Hip abduction is restricted.
2. **Limb shortening on the affected side**: Posterosuperior dislocation of the femoral head on the affected side commonly results in corresponding shortening of the lower limb.
Developmental dysplasia of the hip (DDH), formerly known as congenital hip dislocation, is a relatively common congenital deformity characterized by abnormal or lost articulation between the femoral head and acetabulum within the joint capsule, resulting in impaired normal development both prenatally and postnatally. The etiology of DDH cannot be attributed to a single factor; current understanding suggests that genetic predisposition and primary embryonic tissue defects play significant roles in its pathogenesis.
Clinical Manifestations of Developmental Dysplasia of the Hip in Infants
Hip dislocation in infants falls under the category of congenital hip dislocation, primarily caused by developmental abnormalities of the hip joint. Clinical features include:
1. Limited joint mobility: The affected limb typically remains flexed, exhibits reduced range of motion compared with the unaffected side, and demonstrates diminished蹬踩 (pushing) strength on the affected side. Hip abduction is restricted.
2. Limb shortening: Posterosuperior dislocation of the femoral head commonly results in apparent shortening of the affected lower limb.
3. Skin fold and perineal changes: Asymmetric skin folds over the buttocks and medial thighs are observed; folds on the affected side tend to be deeper and more numerous than those on the unaffected side. In female infants, asymmetry of the labia majora and widening of the perineum may also be present.
The fundamental principle of managing DDH is early diagnosis and prompt intervention. Once congenital hip dislocation is confirmed after birth, treatment should commence immediately to maximize the likelihood of achieving near-normal hip function. Delayed initiation of treatment correlates strongly with poorer clinical outcomes.
1. Conservative management: Bracing, splinting, or casting is selected according to the infant’s age. Ideal devices must provide stable yet comfortable immobilization, allow ease of diapering and toileting, and—preferably—permit controlled, physiological hip motion.
2. Surgical management: Surgical options vary depending on the patient’s age and specific anatomical condition. Common procedures include Salter pelvic osteotomy, Pemberton acetabuloplasty, femoral rotational osteotomy, and femoral shortening osteotomy.
We hope the above information is helpful to you. Wishing you a happy and healthy life!
