Delay in diagnosis of developmental dysplasia of the hip
Developmental dysplasia of the hip is a problem associated with the way that the hip joint develops.
In DDH, there is an abnormality either in the shape of the head of the femur, the shape of the acetabulum, or the supporting structures around them. Consequently, the acetabulum and femur are not in close contact. It is usually present from birth and is more common in girls, first born children and in children of certain racial groups.
About 3 in 10 hip replacement operations performed in people under the age of 60 are due to DDH.
Which babies are affected by developmental dysplasia of the hip?
There are known factors which increase the risk of a baby being born with DDH. These factors include:
- family history - if a parent, brother or sister has DDH, the child is five times more likely to have DDH
- pregnancy conditions - if there is only a small amount of fluid in the uterus (oligohydramnios), this increases the risk of DDH
- breech position - if a foetus is in the breech position, the legs may be in a position which increases the risk of DDH
- DDH is also more common in premature babies or babies born weighing more than 5kg
- other abnormalities - if the baby has cerebral palsy, spinal cord problems or other nerve and muscle disorders, this increases the risk of developing DDH
Most hospitals have protocols which require that babies with some of the risk factors for DDH are scanned in the weeks after delivery. There is no universal scanning program and examination is the main method of detecting DDH in babies who do not fulfil the criteria for scanning.
A newborn baby with DDH will not be in pain. Ideally, babies will be examined within 24 hours of birth, at 6-weeks, between 6-9 months and at walking age. A doctor will bend the baby's knees and turn the thighs outwards, feeling for a clunk which may indicate problems with the hip. Other signs of hip problems are:
- the skin folds between the legs and the body may not be equal on both sides
- the femur may look shorter on one side
If a child with DDH is walking, they may have a limp in their walk or walk on its toes.
Success rate of treatment
The outcome is usually very successful when DDH is diagnosed and treated early in a young baby. Most children who are diagnosed early and treated before six months have an excellent outcome.
However, if the treatment is delayed then more complex treatment is required with less chance of success. The chances of success are reduced once the child has started to walk and once the child’s bones have fully developed. In addition, delayed diagnosis and treatment may lead to early arthritis of the hip joint which causes pain and reduced movement.
How we can help
If you have suffered from delayed diagnosis and/or treatment of DDH, we may be able to help.
Making a claim
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