DDH – General

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)