DDH - A structural abnormality in the hips caused by abnormal development of the fetal bones during pregnancy and a persistantly abnormal relationship between the femoral head and the acetabulum = Instability and an increased risk of subluxation or dislocation

These abnormalities can persist into adulthood leading to weakness, recurrent dislocations, abnormal gait and early degenerative changes

Risk factors:

Risk factors for developmental dysplasia are the 5 Fs:

• Female
• Firstborn
• Family history - sibling or a parent
• Fanny first (breech)
• Fluid (oligohydramnios).

DDH is screened for on the neonatal examination at brith (NIPE) and at 6-8 weeks old. If its not picked up here, will be picked up when child presents with hip asymmetry, reduced ROM in the hip or a limp

Examination

Findings that may suggest DDH are:

• Different leg lengths
• Restricted hip abduction on one side
• Significant bilateral restriction in abduction
• Difference in the knee level when the hips are flexed
• Clunking of the hips on special tests

Positive Ortolani test (for infants <6months):