UMEM Educational Pearls

Category: Orthopedics

Title: Developmental dysplasia of the hip & proper swaddling

Keywords: hip, dislocation, DDH (PubMed Search)

Posted: 10/22/2022 by Brian Corwell, MD (Updated: 12/7/2022)
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Developmental dysplasia of the hip (DDH) 

 

  • A spectrum of conditions related to hip development in infants & young children
  • Results from abnormal development of the acetabulum and proximal femur
  • Results in mechanical instability of the hip joint 
  • Left hip (3:1) vs Right
  • Female sex (5:1)
  • Breech presentation (20%)
  • Family history of DDH
  • Infants and young children with untreated hip dislocation rarely have pain or other limitations.
  • Most affected children begin to walk and reach developmental milestones at the appropriate time.
  • In cultures where tight swaddling with the lower limbs in extension is common, significantly higher rates of DDH have been reported.
  • In South Australia 79% of those with DDH were tightly swaddled
  • In Japan, when traditional swaddling was used, the incidence of DDH was 5%.
  • A public campaign to switch to wrapping techniques encouraging hip flexion and abduction led to DDH rates falling to less than 0.4%.
  • https://res.cloudinary.com/dbwozcf0d/images/f_auto,q_auto/v1589948650/10624649_794826423982877_5167788043433556178_n/10624649_794826423982877_5167788043433556178_n.jpg