OrthoNet

DDH-general
Developmental Dysplasia of the Hip - General

Incidence about 1/1000 (0.1%)
Etiologic associative factors:
- ligamentous laxity
- females about 6-7 times more likely to get it than males (?hormonal effect)
- breech presentation (single or frank breech)
- hereditary component - 10% chance in sisters, 1% chance in brothers

Anatomic Associations
- congenital muscular torticollis - look at the neck!
- metatarsus adductus
- DO A CAREFUL PHYSICAL EXAMINATION - neck, spine, knees, feet, U/E

Pathoanatomy
- loose capsule initially

The eventual pathology that blocks reduction:
- hourglass constriction of capsule which is adherent to pelvic wall
- inverted/infolded labrum
- hypertrophied pulvinar
- hypertrophied ligamentum teres
- transverse acetabular ligament
- tight iliopsoas (worsens the hourglass constriction of the capsule)