Developmental Dysplasia of the Hip.
Last updated Wednesday, February 09, 2005
Management and treatmentHow is developmental dysplasia of the hip treated? Treatment for developmental dysplasia of the hip is dependent upon age.
In the first six months of age, the standard of care is a Pavlik
harness, which holds the hips bent up and out but allows for motion as
the child kicks the legs. Between six and eighteen months, the hip is
examined under general anesthesia. If it can be held safely, the child
is placed in a spica cast (a body cast that holds the hip in the
optimal position to promote proper growth of the socket, or acetabulum,
and ball, or femoral head). If the hip is unstable, it is surgically
opened and any obstacles to reduction (tissues which might be filling
up the acetabulum or in another way preventing the femoral head from
sitting properly in the acetabulum) are cleared; the child then is
placed in a spica cast. After eighteen months of age, it is necessary
to cut the pelvis or the femur to better align the acetabulum and the
femoral so that they can develop normally.What can the patient do to treat or manage developmental dysplasia of the hip? No self-management methods have been shown to work in treating developmental dysplasia of the hip.What health care professionals may help treat or manage developmental dysplasia of the hip? The pediatrician often makes the initial diagnosis. The orthopaedic
surgeon confirms the diagnosis, provides education on the condition,
and treats the condition until resolution. Along the way, other health
care professionals may be involved as deemed necessary by the type of
intervention selected and the type of outcome. For example, nurses
perform preoperative and postoperative management, such as learning how
to care for a spica cast.What medications are used to treat or manage developmental dysplasia of the hip? There are no specific medications for developmental dysplasia of the hip.Can surgery help treat developmental dysplasia of the hip? Surgery can help treat DDH.
After six months of age, surgery is recommended for treatment of
developmental dysplasia of the hip. Between six and eighteen months,
the child is taken to the operating room and the hip is examined under
general anesthesia. If it can be held safely, the child is placed in a
spica cast (a body cast that holds the hip in the optimal position to
promote proper growth of the socket, or acetabulum, and ball, or
femoral head). If the hip is unstable, it is surgically opened and any
obstacles to reduction (tissues which might be filling up the
acetabulum or in another way preventing the femoral head from sitting
properly in the acetabulum) are cleared; the child then is placed in a
spica cast.
After eighteen months of age, it is necessary to cut the pelvis or
the femur to better align the acetabulum and the femoral so that they
can develop normally. The cut bones often require internal fixation, or
the placement of steel implants such as pins or plates, to hold them in
their new position while they heal, and these implants have to be
removed in a second operation. Can splints or braces help treat or manage developmental dysplasia of the hip? During the first six months of life, the standard of care is
application of a Pavlik harness, which is named after the
Czechoslovakian doctor who devised it. This looks like a parachute, and
is easy on the child and the parents. It holds the hips in a flexed
(bent up toward the chest) and abducted (held out to the sides, which
puts the ball, or femoral head, centered or in an optimal position to
induce the socket, or acetabulum, to develop normally.Are there alternative remedies for developmental dysplasia of the hip (herbal, acupuncture, tai chi, yoga, etc)? There are no alternative remedies that have scientifically proven benefits for developmental dysplasia of the hip.What kind of ongoing care or monitoring is necessary for developmental dysplasia of the hip? Children with developmental dyplasia of the hip must be followed by
their orthopaedic surgeon until maturity, because the condition can
recur or "come back" despite successful treatment as long as the
skeleton is still growing.
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