Health alterations class 3- Developmental dysplasia of the hip

Part 2- DDH

Developmental dysplasia of the hip

1. Broad term that describes a spectrum of disorders related to abnormal development of the hip

2. Femoral head and acetabulum improperly aligned

Who is DDH more common in

Girls

Signs/symptoms of DDH

1. Galeazzi sign

2. Limited hip abduction

3. Hip instability (ortolani or Barlow test, trendelenberg sign)

Galeazzi sign

Affected side appears shorter than the non affected side

Asymmetry of gluteal and thigh folds

Affected side has an extra fold in the skin

Ortolani test

abduct legs, click means dislocation

Barlow test

Adduct hip, can feel hip dislocate

Trendelenberg sign

Standing holding chair, legs not aligned indicates a problem with the hips

Complications of DDH

1. Abnormal acetabular development/joint malformation

2. Lordosis

3. Sciatic nerve injury

4. A vascular necrosis of the femoral head

5. Soft tissue damage

6. Permanent disability

Treatment and management of DDH

1. Pavlik harness

2. Spica cast

3. Traction (skin or skeletal)

4. Surgical correction

When is the pavlik harness used

Newborn to 6 months

When is the spica cast used

6 to 18 months

When is traction and surgical correction used

When other methods don’t work, typically over the age of 2

What does it mean to pedal a spica cast

Use waterproof tape on the cast to protect the edges/openings

How does a child in a spica cast wear a diaper

1. Pedal the cast

2. Smaller diaper inside

3. Bigger diaper over

How does wearing a spica cast affect a child’s development

Temporary slows development such as walking, child catches up once cast is off

How often is a pavlik harness adjusted

Once a week by a doctor or parents. (If rural area/limited access, guided by a doctor)