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Developmental dysplasia of the hip (DDH) is a spectrum of abnormalities in hip development, ranging from shallow acetabulum (acetabular dysplasia) to subluxation and frank dislocation of the femoral head.

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It is a congenital/developmental condition present at birth or manifesting in early childhood.

https://www.youtube.com/watch?v=5EPgLJMZb_s

https://youtu.be/QVuMj_Imsl8

Etiopathology

Risk factors:

• Mechanical factors: Breech presentation, oligohydramnios, first-born child (tight uterus).
• Hormonal: Maternal relaxin → ligamentous laxity.
• Genetic: Positive family history.
• Demographics: More common in females (6:1), left hip > right, ~20% bilateral.

Pathology

• Abnormal acetabular development → shallow acetabulum.
• Instability → femoral head subluxates/dislocates.
• If untreated: Progressive deformity, limb shortening, Trendelenburg gait, secondary osteoarthritis.

Clinical Features

• Asymmetrical thigh/gluteal folds.