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Dysplasie développementale de la hancheDDysplasie développementale de la hancheDevelopmental dysplasia of the hipFrenchOrthopaedics/MusculoskeletalNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months)HipSkeletal systemConditions and diseasesCaregivers Adult (19+)NA2010-03-05T05:00:00Z6.0000000000000070.0000000000000648.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Aperçu facile à comprendre des signes, des symptômes, des causes et du traitement de cette condition anormale de la hanche d’un enfant.</p><h2>Qu’est-ce que la dysplasie développementale de la hanche (DDH)? </h2> <p>La dysplasie développementale de la hanche (DDH) consiste en une articulation de la hanche anormale. Certains bébés naissent avec cette maladie génétique. La tête de l’os de la cuisse (fémur) ne s’emboîte pas parfaitement dans l’articulation. Il peut en résulter une claudication (boitement) et de la douleur. Dans les cas les plus graves, cette maladie génétique peut être invalidante. </p> <p>Cette maladie affecte environ un bébé sur 1 000. On peut observer une légère instabilité de la hanche chez un nouveau-né sur trois. Les filles ont davantage de risques que les garçons de développer une dysplasie de la hanche. Ce trouble peut être d’origine génétique.</p><h2>À retenir</h2> <ul> <li>La DDH sest le fait que la tête de l’os de la cuisse est mal insérée dans l’articulation de la hanche.</li> <li>Les bébés qui se présentent par le siège ou qui ont des antécédents familiaux de DDH ont des risques accrus de présenter ce trouble.</li> <li>Les signes comprennent l’incapacité du bébé de bouger la cuisse vers l'extérieur au niveau de la hanche et, plus tard, de la difficulté à marcher et de la douleur.</li> <li>On utilise le harnais de Pavlik pour corriger la DDH.</li> <li>Environ un bébé sur 20 qui présente une DDH a besoin d’une chirurgie pour corriger la malformation.</li> </ul><h2>Signes et symptômes de la DDH</h2> <p>Un bébé atteint d’une DDH pourrait ne montrer aucun signe du trouble. Les signes sont parfois très subtils. Ils peuvent varier selon l’âge de l'enfant. Les signes que votre médecin vérifiera comprennent, sans toutefois s’y limiter, les suivants :</p> <ul> <li>léger bruit audible en ouvrant et en refermant les jambes;</li> <li>incapacité de bouger la cuisse vers l’extérieur au niveau de la hanche;</li> <li>jambes de longueurs différentes;</li> <li>inégalité des replis de gras de la cuisse autour de l’aine ou des fesses;</li> <li>claudication ou marche sur les orteils d’un pied chez les enfants plus âgés;</li> <li>courbure de la colonne vertébrale chez les enfants plus âgés.</li> </ul><h2>Causes de la dysplasie développementale de la hanche</h2> <p>Les médecins ne savent pas exactement ce qui cause la DDH. Certains facteurs de risque peuvent faire augmenter les risques que votre enfant naisse avec une DDH. Ces facteurs comprennent :</p> <ul> <li>des antécédents familiaux de DDH;</li> <li>le fait que le bébé se présente par le <a href="/article?contentid=412&language=French">siège</a> à la naissance;</li> <li>une baisse du liquide amniotique dans l’utérus;</li> <li>des problèmes de la musculature ou du squelette.</li> </ul><h2>Comment le médecin peut aider votre enfant</h2> <p>Le médecin de famille procédera à un examen physique. S’il pense que votre enfant a une DDH, il pourrait l’adresser à un chirurgien orthopédique. On effectuera habituellement une échographie et une radiographie.</p><h2>Traitement</h2><p>Le traitement dépend de l’âge de votre enfant et de la sévérité de la DDH. Les cas légers se corrigent sans traitement après quelques semaines. Les cas graves nécessitent un traitement.</p><h3>Harnais</h3><p>Si le diagnostic est assez précoce, le médecin pourrait demander que votre enfant porte une orthèse que l’on appelle un <a href="/Article?contentid=971&language=French">harnais (ou attelle) de Pavlik</a>. Il s’agit d’un ensemble de courroies qui maintiennent votre enfant dans une position semblable à celle d’une grenouille. Le harnais permet à l’articulation de la hanche de se développer normalement. Votre chirurgien orthopédique vous dira pendant combien de temps votre bébé devra porter l’orthèse. </p><p>Environ un bébé sur 20 qui a une DDH a besoin d’autre chose que le harnais de Pavlik pour corriger la malformation.</p><h3>Chirurgie</h3><p>Les enfants plus âgés pourraient avoir besoin d’un des deux traitements qui suivent.</p><p>On pratique habituellement la réduction orthopédique sur les enfants âgés de 18 mois et moins. Pendant ce traitement, on replace manuellement l’os dans la cavité de la hanche pendant que l’enfant est sous <a href="/article?contentid=1261&language=French">anesthésie</a>.</p><p>On pratique habituellement la réduction pare chirurgie (réduction sanglante) sur les enfants âgés de 18 mois et plus. Pendant cette chirurgie, les muscles et les tissus qui entourent la hanche sont relâchés pendant que l’on réaligne la hanche et que l’os de la cuisse est replacé dans la cavité. Les muscles et les tissus sont resserrés une fois la hanche réalignée.</p><h2>Complications</h2> <p>If DDH is not treated early, the hip joint does not form properly. This will result in difficulty moving the hips normally. This may become obvious when the child starts to walk. It may cause pain as they grow older.</p><h2>When to seek medical assistance</h2> <p>If you suspect your child's hips are not developing properly, see a doctor as soon as possible.</p>
خلل التنسج النمائي للوركخخلل التنسج النمائي للوركDevelopmental dysplasia of the hip (DDH)ArabicOrthopaedics/MusculoskeletalNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months)HipSkeletal systemConditions and diseasesCaregivers Adult (19+)NA2010-03-05T05:00:00Z6.0000000000000070.0000000000000648.000000000000Flat ContentHealth A-Z<h2>النقاط‮ ‬الرئيسية</h2><ul><li>خلل‮ ‬التنسج‮ ‬النمائي‮ ‬للورك‮ ‬يعني‮ ‬ان‮ ‬رأس‮ ‬عظم‮ ‬الفخذ‮ ‬لم‮ ‬يتم‮ ‬ادخاله‮ ‬بشكل‮ ‬صحيح‮ ‬في‮ ‬مفصل‮ ‬الورك.</li><li>الاطفال‮ ‬المقعدين‮ ‬او‮ ‬الذين‮ ‬لديهم‮ ‬تاريخ‮ ‬عائلي‮ ‬مع‮ ‬خلل‮ ‬التنسج‮ ‬النمائي‮ ‬للورك‮ ‬من‮ ‬المرجح‮ ‬اكثر‮ ‬ان‮ ‬تكون‮ ‬لديهم‮ ‬هذه‮ ‬الحالة.</li><li>تشمل‮ ‬العلامات‮ ‬عدم‮ ‬قدرة‮ ‬الطفل‮ ‬على‮ ‬تحريك‮ ‬فخذه‮ ‬الى‮ ‬الخارج‮ ‬عند‮ ‬الورك‮ ‬ولاحقا‮ ‬سيجد‮ ‬صعوبة‮ ‬في‮ ‬المشي‮ ‬ويعاني‮ ‬من‮ ‬الألم.</li><li>يستخدم‮ ‬جهاز‮ ‬مقوام‮ ‬پاڤليك‮ ‬لتصحيح‮ ‬خلل‮ ‬التنسج‮ ‬النمائي‮ ‬للورك.</li><li>قد‮ ‬يحتاج‮ ‬طفل‮ ‬من‮ ‬كل‮ ‬20‮ ‬طفل‮ ‬المصابين‮ ‬بخلل‮ ‬التنسج‮ ‬النمائي‮ ‬للورك‮ ‬الى‮ ‬عملية‮ ‬جراحية‮ ‬لتصحيح‮ ‬الحالة.<br></li></ul>
Displasia congénita de la caderaDDisplasia congénita de la caderaDevelopmental Dysplasia of the Hip (DDH)SpanishNAChild (0-12 years);Teen (13-18 years)NANANAAdult (19+)NA2010-03-05T05:00:00Z70.00000000000006.00000000000000648.000000000000Flat ContentHealth A-Z<p>La displasia del desarrollo de la cadera (DCC) es una afección en la articulación de la cadera. Lea información sobre la DCC, su causa y el arnés de Pavlik.</p>
இடுப்பின் இயல்பு பிறழ்ந்த வளர்ச்சிஇடுப்பின் இயல்பு பிறழ்ந்த வளர்ச்சிDevelopmental Dysplasia of the Hip (DDH)TamilNAChild (0-12 years);Teen (13-18 years)NANANAAdult (19+)NA2010-03-05T05:00:00Z70.00000000000006.00000000000000648.000000000000Flat ContentHealth A-Z<p>ஒரு பிள்ளையின் இடுப்பின் இந்த அசாதாரண நிலைக்கான அடையாளங்கள், அறிகுறிகள், காரணங்கள், மற்றும் சிகிச்சை பற்றி இலகுவாக விளங்கிக் கொள்வதற்கான ஒரு கண்ணோட்டம்.</p>
کولھے کی یڈی کا غیر فطری ابھارککولھے کی یڈی کا غیر فطری ابھارDevelopmental Dysplasia of the Hip (DDH)UrduNAChild (0-12 years);Teen (13-18 years)NANANAAdult (19+)NA2010-03-05T05:00:00Z70.00000000000006.00000000000000648.000000000000Flat ContentHealth A-Z
What is developmental dysplasia of the hip (DDH)?WWhat is developmental dysplasia of the hip (DDH)?What is developmental dysplasia of the hip (DDH)?EnglishOrthopaedics/MusculoskeletalNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months)HipSkeletal systemConditions and diseasesCaregivers Adult (19+)NA2022-10-17T04:00:00Z9.4000000000000057.0000000000000979.000000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the signs, symptoms, causes and treatment of developmental dysplasia of the hip (DDH).</p><h2>What is developmental dysplasia of the hip (DDH)? </h2><p>Developmental dysplasia of the hip (DDH) is a term used for babies or children who have instability of the hip joint which ranges from mild to severe. The infant or child may have general looseness of the hip (mild) or they may have a fully dislocated hip (severe). DDH is extremely common. DDH can occur in one or both hips.</p><ul><li>1 in 10 infants are born with hip instability. </li><li>1 in 100 infants are treated for hip dysplasia. </li><li>1 in 500 are born with completely dislocated hips. </li></ul><h2>Hip joint anatomy</h2><p>The hip joint is a "ball and socket" joint. The "ball" is the top of the femur (the thigh bone) and is called the femoral head. The "socket" is the dome shaped opening in the pelvis called the acetabulum. The femoral head is held in the acetabulum by the shape of the bones, the muscles surrounding the hip and the capsule, which is a fibrous tissue structure that holds joints in place. </p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Hipjoint_Anatomy_Infant.jpg" alt="hipjoint anatomy in infant showing the acetabulum or hip socket, the femoral head, the femur, and the hip capsule" /> </figure> <h2>Severity of DDH</h2> <figure class="asset-c-100"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Severity_of_Dysplastic_Hip_Column_Flip.jpg" alt="" /> </figure> <p>In the <strong>normal hip</strong>, the femoral head and the acetabulum are normally shaped, they fit together perfectly and the joint is held tightly in place.</p><p>In a <strong>dysplastic or subluxable hip</strong> there is a shallow acetabulum. The femoral head is located inside the abnormal acetabulum. They do not fit together perfectly. In a stable dysplastic hip, the joint is held tightly in place. In a subluxable hip the femoral head can be gently moved by a health-care provider.</p><p>In a <strong>subluxable hip</strong>, there is a shallow acetabulum. The femoral head is located inside the abnormal acetabulum but can be gently moved outside of the acetabulum by a health-care provider because there is excessive looseness of the joint. </p><p>In a <strong>subluxated hip</strong>, there is a shallow acetabulum. The femoral head is not perfectly located inside the abnormal acetabulum at rest; therefore, the hip is considered unstable. The femoral head can be further moved outside of the socket by a health-care provider because there is excessive looseness of the joint. </p><p>In a <strong>dislocated hip</strong> the femoral head is sitting completely outside of the abnormally shaped shallow acetabulum; therefore, the hip is considered unstable. In some cases the femoral head can be easily moved back into the acetabulum with gentle maneuvers by the health-care provider; this is called a reducible dislocated hip. When the femoral head is moved back into the acetabulum, it may create a sound known as a "clunk". In other cases the femoral head cannot be moved back into the acetabulum by the health-care provider. This is called an irreducible dislocated hip; it is the most severe type of DDH.</p><p>Both the severity of DDH as well as the age of the infant at diagnosis will direct the treatment plan. </p><h2>Key points</h2><ul><li>Developmental dysplasia of the hip (DDH) means that the hip joint (ball and socket) has not formed properly, so that the ball (top of the femur / thigh bone) is not properly inside the socket (the acetabulum).</li><li>Girls and first-born infants are at a higher risk of having DDH. Breech position and family history of the condition are also risk factors for DDH.</li><li>A primary care provider completes the initial exam of the infant and may refer the infant to a specialist clinic if they are concerned about the hips.</li><li>1 in 100 infants require treatment to correct DDH. </li></ul><h2>What are the causes of DDH? </h2> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Hip_dysplasia_Infographic.jpg" alt="" /> </figure> <p>DDH develops close to the time of birth, after birth or during childhood. The exact causes of DDH are not known. Some risk factors can increase your child’s chances of being born with DDH. These include: </p><ul><li>female babies (8 in 10 cases)</li><li>firstborn babies (6 in 10 cases)</li><li>family history of DDH</li><ul><li>If a child has DDH, the risk of another child having it is 6% (1 in 17).</li><li>If a parent has DDH, the risk of a child having it is 12% (1 in 8).</li><li>If a parent and a child have DDH, the risk of a subsequent child having DDH is 36% (1 in 3).</li></ul><li>breech position (when the fetus is positioned feet first or bottom first)</li><li>decreased amniotic fluid in the womb (oligohydramnios)</li><li>problems with the muscular or skeletal system </li></ul> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Breech_baby.jpg" alt="Baby in head down position in uterus compared to baby in breech position in uterus" /> </figure> <h2>How is DDH diagnosed?</h2><p>In Ontario, a clinical examination is used to look for DDH in babies at birth and at their well-baby check-ups by their primary care provider. Signs of DDH may be very subtle and may vary depending on the child’s age. DDH can be difficult to detect and not all cases of DDH will be picked up during these examinations. Some of the signs your primary care provider will look for include: </p><ul><li>an audible "clunk" during the opening and closing of the hips</li><li>inability to move the thigh outward at the hip</li><li>one leg shorter than the other</li><li>unevenness in the fat folds of the thigh around the groin or buttocks</li><li>limping or walking on the toes of one foot in older children</li><li>a spine curve in older children</li></ul><p>If your primary care provider is concerned about the results of the physical exam in the newborn, then they may order an <a href="/article?contentid=1290&language=english">ultrasound</a> of the hips to look more closely. The child may also be referred for ultrasound if there are multiple risk factors, including being a girl, first born and born in a breech presentation. All breech babies and those with a family history of DDH should have a screening hip ultrasound at 6 weeks of age.</p><h2>Referral to a specialist at SickKids</h2><p>Depending on the primary care provider’s findings, the infant may be referred to a specialist clinic for further examination of the hips. When newborn babies are referred to SickKids, they are seen by an interprofessional health-care team in the one-stop <a href="https://www.sickkids.ca/en/care-services/clinics/baby-hip-clinic/">Baby Hip Clinic</a>. Walking age children are seen in one of the general orthopaedic clinics by an orthopaedic surgeon and their team.</p>

 

 

 

 

What is developmental dysplasia of the hip (DDH)?944.000000000000What is developmental dysplasia of the hip (DDH)?What is developmental dysplasia of the hip (DDH)?WEnglishOrthopaedics/MusculoskeletalNewborn (0-28 days);Baby (1-12 months);Toddler (13-24 months)HipSkeletal systemConditions and diseasesCaregivers Adult (19+)NA2022-10-17T04:00:00Z9.4000000000000057.0000000000000979.000000000000Health (A-Z) - ConditionsHealth A-Z<p>An overview of the signs, symptoms, causes and treatment of developmental dysplasia of the hip (DDH).</p><h2>What is developmental dysplasia of the hip (DDH)? </h2><p>Developmental dysplasia of the hip (DDH) is a term used for babies or children who have instability of the hip joint which ranges from mild to severe. The infant or child may have general looseness of the hip (mild) or they may have a fully dislocated hip (severe). DDH is extremely common. DDH can occur in one or both hips.</p><ul><li>1 in 10 infants are born with hip instability. </li><li>1 in 100 infants are treated for hip dysplasia. </li><li>1 in 500 are born with completely dislocated hips. </li></ul><h2>Hip joint anatomy</h2><p>The hip joint is a "ball and socket" joint. The "ball" is the top of the femur (the thigh bone) and is called the femoral head. The "socket" is the dome shaped opening in the pelvis called the acetabulum. The femoral head is held in the acetabulum by the shape of the bones, the muscles surrounding the hip and the capsule, which is a fibrous tissue structure that holds joints in place. </p> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Hipjoint_Anatomy_Infant.jpg" alt="hipjoint anatomy in infant showing the acetabulum or hip socket, the femoral head, the femur, and the hip capsule" /> </figure> <h2>Severity of DDH</h2> <figure class="asset-c-100"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Severity_of_Dysplastic_Hip_Column_Flip.jpg" alt="" /> </figure> <p>In the <strong>normal hip</strong>, the femoral head and the acetabulum are normally shaped, they fit together perfectly and the joint is held tightly in place.</p><p>In a <strong>dysplastic or subluxable hip</strong> there is a shallow acetabulum. The femoral head is located inside the abnormal acetabulum. They do not fit together perfectly. In a stable dysplastic hip, the joint is held tightly in place. In a subluxable hip the femoral head can be gently moved by a health-care provider.</p><p>In a <strong>subluxable hip</strong>, there is a shallow acetabulum. The femoral head is located inside the abnormal acetabulum but can be gently moved outside of the acetabulum by a health-care provider because there is excessive looseness of the joint. </p><p>In a <strong>subluxated hip</strong>, there is a shallow acetabulum. The femoral head is not perfectly located inside the abnormal acetabulum at rest; therefore, the hip is considered unstable. The femoral head can be further moved outside of the socket by a health-care provider because there is excessive looseness of the joint. </p><p>In a <strong>dislocated hip</strong> the femoral head is sitting completely outside of the abnormally shaped shallow acetabulum; therefore, the hip is considered unstable. In some cases the femoral head can be easily moved back into the acetabulum with gentle maneuvers by the health-care provider; this is called a reducible dislocated hip. When the femoral head is moved back into the acetabulum, it may create a sound known as a "clunk". In other cases the femoral head cannot be moved back into the acetabulum by the health-care provider. This is called an irreducible dislocated hip; it is the most severe type of DDH.</p><p>Both the severity of DDH as well as the age of the infant at diagnosis will direct the treatment plan. </p><h2>Key points</h2><ul><li>Developmental dysplasia of the hip (DDH) means that the hip joint (ball and socket) has not formed properly, so that the ball (top of the femur / thigh bone) is not properly inside the socket (the acetabulum).</li><li>Girls and first-born infants are at a higher risk of having DDH. Breech position and family history of the condition are also risk factors for DDH.</li><li>A primary care provider completes the initial exam of the infant and may refer the infant to a specialist clinic if they are concerned about the hips.</li><li>1 in 100 infants require treatment to correct DDH. </li></ul><h2>What are the causes of DDH? </h2> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Hip_dysplasia_Infographic.jpg" alt="" /> </figure> <p>DDH develops close to the time of birth, after birth or during childhood. The exact causes of DDH are not known. Some risk factors can increase your child’s chances of being born with DDH. These include: </p><ul><li>female babies (8 in 10 cases)</li><li>firstborn babies (6 in 10 cases)</li><li>family history of DDH</li><ul><li>If a child has DDH, the risk of another child having it is 6% (1 in 17).</li><li>If a parent has DDH, the risk of a child having it is 12% (1 in 8).</li><li>If a parent and a child have DDH, the risk of a subsequent child having DDH is 36% (1 in 3).</li></ul><li>breech position (when the fetus is positioned feet first or bottom first)</li><li>decreased amniotic fluid in the womb (oligohydramnios)</li><li>problems with the muscular or skeletal system </li></ul> <figure class="asset-c-80"> <img src="https://assets.aboutkidshealth.ca/AKHAssets/Breech_baby.jpg" alt="Baby in head down position in uterus compared to baby in breech position in uterus" /> </figure> <h2>How is DDH diagnosed?</h2><p>In Ontario, a clinical examination is used to look for DDH in babies at birth and at their well-baby check-ups by their primary care provider. Signs of DDH may be very subtle and may vary depending on the child’s age. DDH can be difficult to detect and not all cases of DDH will be picked up during these examinations. Some of the signs your primary care provider will look for include: </p><ul><li>an audible "clunk" during the opening and closing of the hips</li><li>inability to move the thigh outward at the hip</li><li>one leg shorter than the other</li><li>unevenness in the fat folds of the thigh around the groin or buttocks</li><li>limping or walking on the toes of one foot in older children</li><li>a spine curve in older children</li></ul><p>If your primary care provider is concerned about the results of the physical exam in the newborn, then they may order an <a href="/article?contentid=1290&language=english">ultrasound</a> of the hips to look more closely. The child may also be referred for ultrasound if there are multiple risk factors, including being a girl, first born and born in a breech presentation. All breech babies and those with a family history of DDH should have a screening hip ultrasound at 6 weeks of age.</p><h2>Referral to a specialist at SickKids</h2><p>Depending on the primary care provider’s findings, the infant may be referred to a specialist clinic for further examination of the hips. When newborn babies are referred to SickKids, they are seen by an interprofessional health-care team in the one-stop <a href="https://www.sickkids.ca/en/care-services/clinics/baby-hip-clinic/">Baby Hip Clinic</a>. Walking age children are seen in one of the general orthopaedic clinics by an orthopaedic surgeon and their team.</p>https://assets.aboutkidshealth.ca/AKHAssets/Hipjoint_Anatomy_Infant.jpgTrue

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