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DISLOCATION OF HIP

Congenital dislocation of hip (recently called developmental dysplasia of hip or DDH) is detected quite late in the Indian scenario. It is not very common in India, incidence being approximately 0.1% (1 per 1000) in South India. What causes DDH is largely unknown; if someone in family has it, others are more likely to get it (genetic predisposition). Also, some other risk factors have been identified (first born female child with breech (bottom down) presentation at birth).
DDH encompasses a wide spectrum of disorders which presents itself at different ages with different symptoms.
Especially when a child is affected parents are always on the run for the best spine surgeons in Bangalore. In a non walking child, DDH usually presents as shortness of thigh compared to the opposite side, additional skin creases on the thigh on affected side or reduced outward movement at hip (abduction) specially noticed while changing diapers.
When the child with DDH starts walking, parents notice either a lurch to one side or duck like waddle (when problem is on both sides). Besides, parents also bring children with complaints of out-toeing (feet turned out- Like Charlie Chaplin). The affected leg is short; may manifest as lurch, toe walking on one side or abnormal curvature of spine.
Before 6 months of age, Ultrasound is effective in diagnosing the problem. Afterwards, X- rays are helpful.
When detected early, treatment is simple. Special belts (Pavlik harness) or braces are effective in newborns. Special plasters (hip spica) are required at a later age while surgery is often required when it is detected very late.