Developmental Hip Dysplasia (DDH) is a term that has replaced the term Congenital Hip Dislocation (CHD) in recent years. This disease is essentially a disturbance of the relationship between the ball (femoral head) and socket (acetabulum) in the hip joint to varying degrees. In this condition, the ball may be outside the socket or dislocated from the socket in certain positions to varying degrees. Symptoms and examination findings may be obvious or unnoticed depending on the degree of the disease in newborns.

Hip Dislocations Previously, it was believed that all hip dislocations were present from birth and progressed over time. Recent studies have shown that some children who are diagnosed with hip dislocation at an advanced age may have been normal at birth and during standard ultrasound examinations. The current accepted view is that babies who are eventually treated for hip dysplasia may not have been born with a dislocation, but the joint capsule that stabilizes the ball-socket joint may be loose, and the ball and socket may move away from each other at varying degrees over time. For these reasons, the term CHD has been replaced with DDH.

Symptoms of DDH: There may be no symptoms in newborns and children with mild dislocations until they start walking. These babies are usually identified by pediatricians during routine examinations.

Common symptoms include:

  • Leg length discrepancy
  • Difference in the folds of the hip and upper thigh on both sides (skin fold differences occur in approximately 20% of babies with DDH)
  • Less movement or flexibility in one leg
  • “Waddling” gait when walking, called duck walk. Children with these symptoms should be taken to an experienced orthopedic specialist without delay.

Diagnosis: Good examination is essential for a diagnosis. Babies who are not in the risk group and have normal examination are followed up monthly during the first 3 months. After that, the doctor can continue or end the follow-up.

Babies who are at risk, such as those with a family history of hip dislocation, those who were in the breech position with straight and stuck legs, those born with their feet above their shoulders, girls, twins, firstborns, and those with congenital torticollis, have an increased risk. For this reason, the American Academy of Pediatrics recommends ultrasound screening for all babies in the risk group, even if their examinations are normal. However, it is crucial to perform the ultrasound using a special method and by experienced individuals to obtain reliable results. Direct X-ray examination is sufficient to provide information in babies aged 6-8 months, as the ossification of the femoral head varies from baby to baby.

Treatment: The treatment method depends on the age of the child.

  • Newborns: Special braces (such as the Pavlik brace) developed for DDH treatment are used as soon as the diagnosis is made. Methods without angular control, such as the double diaper, pose risks such as delaying treatment and inadequate results.

  • Infants aged 1-6 months: After the dislocation is reduced by intervention or brace application, brace application is continued. In cases where the dislocation cannot be reduced or stays in place in the brace, a plaster application can be made under general anesthesia.

  • Infants aged 6-12 months: Depending on the angle at which the hip is fixed after being placed in its place under general anesthesia, a brace or plaster application can be applied. In cases where the hip cannot be reduced despite anesthesia, surgery may be necessary. After surgery, a plaster application is made.

  • Infants over 1 year old: Surgery is necessary for almost all cases (closed methods may be successful until 1.5 years of