UMEM Educational Pearls

Category: Orthopedics

Title: Developmental dysplasia of the hip & proper swaddling

Keywords: hip, dislocation, DDH (PubMed Search)

Posted: 10/22/2022 by Brian Corwell, MD (Updated: 4/20/2024)
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Developmental dysplasia of the hip (DDH)

A spectrum of conditions related to hip development in infants & young children
Results from abnormal development of the acetabulum and proximal femur
Results in mechanical instability of the hip joint
Left hip (3:1) vs Right
Female sex (5:1)
Breech presentation (20%)
Family history of DDH
Infants and young children with untreated hip dislocation rarely have pain or other limitations.
Most affected children begin to walk and reach developmental milestones at the appropriate time.
In cultures where tight swaddling with the lower limbs in extension is common, significantly higher rates of DDH have been reported.
In South Australia 79% of those with DDH were tightly swaddled
In Japan, when traditional swaddling was used, the incidence of DDH was 5%.
A public campaign to switch to wrapping techniques encouraging hip flexion and abduction led to DDH rates falling to less than 0.4%.
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