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Developmental hip dysplasia is a relatively common abnormality of the hip joint, occurring on a spectrum of abnormality in relation to the joint’s stability and/or shape. The severity of DDH ranges from just a minor looseness of the ligament that holds the ball in the socket to a complete dislocation, in which the ball is entirely out of the socket. Common signs of DDH include:
• the leg on the side of the dislocated hip may appear shorter
• the leg on the side of the dislocated hip may turn outward
• the folds in the skin of the thigh or buttocks may appear uneven
• the space between the legs may look wider than normal
In hip dysplasia, the socket (acetabulum) is too shallow and/or the ligaments too loose—allowing the ball of the thigh bone (femoral head) to slip partially or completely in and out of the hip socket. The risk for hip dysplasia and hip instability increases with any situation that stretches the baby’s hip ligaments (an issue of stability) or causes her legs and hips to be positioned so that the ball of the thigh bone slips out of the hip socket (an issue of shape). The risk is higher for:
• children in families where there’s a genetic predisposition for
• females, who have looser ligaments than males
• first-born babies, whose fit in the uterus is tighter than in later babies
• breech babies, whose constrained position tends to strain the joint’s ligaments
In a very young child who develops DDH, there’s usually little or no pain, but pain may develop as the child begins to walk. If untreated or undertreated in childhood, DDH is the most common cause of early arthritis (and its attendant disability) in young adults. Untreated, the condition can also cause pain, a limp and/or differences in leg length.
The vast majority of children treated for DDH at Boston Children’s Child and Young Adult Hip Preservation Program have corrections that enable their bones to grow normally—so they can walk, play, grow and live active lives. Diagnosing and treating your child’s DDH in infancy greatly increases the likelihood of a successful outcome.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”