DDH

Question 1

What are the risk factors for DDH?

Answer 1

Female
Family history of DDH
Breech presentation
Oligohydraminos
Birthweight >5kg 
Congenital Calceneovalgus foot deformity
Firstborn child

Question 2

How is DDH normally detected?

Answer 2

During NIPE- clunking on barlow and otolani test
Barlow attempts to dislocated an articulated hip
Otolani attempts to relocate an unarticulated hip

Other key features

• symmetrical limb length
• position of knees when hip flexed
• restricted abduction of hip in flexion

Question 3

What investigations should be done?

Answer 3

<4.5months USS
>4.5 months XR

All babies with positive finding referred as well as

• first degree family member with DDH
• breech presentation at or after 36wks
• Multiple pregnancy

Question 4

How is DDH managed?

Answer 4

Hip normally spontaneously stabilises at 3-6wks
Pavliks harness if less than 6 months to ensure hip is in correct position as baby grows until it stabilises
After 6 months- surgery will be needed