Materiały źródłowe

• #1

  https://www.orthobullets.com/pediatrics/4118/developmental-dysplasia-of-the-hip-ddh

  Developmental Dysplasia of the Hip is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation of the hip secondary to capsular laxity and mechanical instability. […] Diagnosis can be confirmed with ultrasonography in the first 4 months and then with radiographs after femoral head ossification occurs (~ 4-6 months). […] Treatment varies from Pavlik bracing to surgical reduction and osteotomies depending on the age of the patient, underlying etiology, and the severity of dysplasia. […] Non-operative treatment includes abduction splinting/bracing (Pavlik harness) for infants 6 months old and with a reducible hip. […] Closed reduction and spica casting are indicated for children 6-18 months old who have failed Pavlik treatment. […] Operative options include open reduction and spica casting for those 18 months old or older, and open reduction with femoral osteotomy for children 2 years old with residual hip dysplasia.

• #2 Developmental Dysplasia of the Hip (DDH) – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/developmental-dislocation-dysplasia-of-the-hip-ddh/

  Developmental Dislocation (Dysplasia) of the Hip (DDH) […] The hip is a ball-and-socket joint. In a normal hip, the ball at the upper end of the thighbone (femur) fits firmly into the socket, which is part of the large pelvis bone. In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. The ball is loose in the socket and may be easy to dislocate. […] When DDH is detected at birth, it can usually be corrected with the use of a harness or brace. […] The baby may be placed in a soft positioning device, called a Pavlik harness, for 1 to 3 months to keep the thighbone in the socket. This special brace is designed to hold the hip in the proper position while allowing free movement of the legs and easy diaper care. The Pavlik harness helps tighten the ligaments around the hip joint and promotes normal hip socket formation.

• #3 Treatment for Developmental Dysplasia of the Hip or DDH | HSS

  https://www.hss.edu/conditions_developmental-dysplasia-of-the-hip-ddh.asp

  Developmental dysplasia of the hip (DDH), also known as developmental pediatric dysplasia of the hip or hip dysplasia, describes a spectrum of hip joint abnormalities that vary in severity from a complete dislocation of the hip joint to mild irregularities of the located hip joint. […] In children, hip dysplasia more frequently affects the left hip than the right. About 80% of cases follow this pattern. The condition can, however, be present in both hips. […] Early intervention is essential to ensure the bones that make up the hip joint develop properly. Incorrect growth in either the ball or socket can cause formation problems in the other. The goal is to achieve and maintain joint congruity. […] When treatment is required, the first choice for children under six months old is nonsurgical, using a Pavlik harness.

• #4 Developmental Dysplasia of the Hip – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563157/

  Developmental dysplasia of the hip encompasses several hip abnormalities, including instability, acetabular dysplasia, subluxation, and dislocation. It typically occurs in children with no other comorbid or underlying conditions. While some cases may resolve spontaneously, others necessitate early intervention to prevent complications in adulthood. Accurate identification of the specific hip disorder is crucial for determining the appropriate management and expected prognosis. […] Diagnosing developmental dysplasia of the hip involves clinical screening and imaging studies. Clinical examination, including the Ortolani test, the Barlow maneuver, and observation of specific physical signs, aids in early detection. Further x-ray or ultrasound imaging evaluation is warranted based on the clinical findings and the patient’s age. Early diagnosis and management are paramount to prevent long-term complications such as persistent dislocation and early hip osteoarthritis. Management options range from conservative measures to surgical interventions, with individualized approaches tailored to the severity of the condition and the patient’s age.

• #5 Developmental Dysplasia of the Hip (DDH) – Seattle Children’s Hospital

  https://www.seattlechildrens.org/conditions/developmental-dysplasia-of-the-hip/

  Developmental dysplasia of the hip (DDH) is the name for a wide range of problems with the way a child’s hips form. […] We can successfully treat most infants and children who have DDH. For the best results, it is important to start treatment early. Early treatment with a harness or brace helps avoid the need for surgery. […] To treat DDH successfully, it is important to find the condition early. The most helpful type of treatment depends on how old your child is when DDH is found. […] All types of treatment have the same goal: putting the hip joint back in place and keeping it there. This kind of treatment is called reduction. […] If a Pavlik harness does not work for your child after a month or so, we may try a more rigid brace (fixed hip abduction brace like the Rhino Cruiser or Ilfeld brace).

• #6 Hip Dysplasia (DDH): Symptoms, Testing and Treatment

  https://www.nationwidechildrens.org/conditions/hip-dysplasia

  Ideally, DDH is detected by routine history and physical exam in the neonatal period. […] Clinical screening is the gold standard for diagnosis with dynamic hip examinations carried out at birth and at subsequent pediatrician visits throughout childhood. […] The Ortolani test and Barlow maneuver should be done at each exam. […] With an unstable, Ortolani positive hip, early treatment is required. Reduced hips are positioned in flexion and mild abduction to stimulate normal joint development, most commonly performed via the Pavlik harness, a dynamic brace which positions the thighs to allow and maintain hip reduction. […] Infants are followed bi-weekly for strap adjustment. Progress is monitored and reduction verified with subsequent US evaluations. […] Treatment success depends on the child’s age and the success of repositioning. Many cases treated in the first 6 months of life with a Pavlik harness recover and develop normally with no long-term problems.

• #7 Developmental dysplasia of the hip in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/developmental-dysplasia-of-the-hip-in-neonates

  All newborn infants should have the hips tested for instability or dislocation. […] Early detection of hip dysplasia is vital. […] The longer the hip is in an abnormal position, the more likely surgical correction will be required. […] If DDH is left untreated the hip joint develops abnormally and surgical reduction is required. By contrast, early conservative management with splinting (for example, Denis-Browne splint) or Pavlik harness allows the hip joint to develop normally and avoids the need for surgery in most cases. […] Infants in whom either test is positive should be assessed by an experienced clinician prior to discharge and fitted with a splint/harness. In the absence of an experienced clinician at your health service, referral to an orthopaedic specialist is desirable.

• #8 Hip Dysplasia (DDH): Symptoms, Testing and Treatment

  https://www.nationwidechildrens.org/conditions/hip-dysplasia

  Ideally, DDH is detected by routine history and physical exam in the neonatal period. […] Clinical screening is the gold standard for diagnosis with dynamic hip examinations carried out at birth and at subsequent pediatrician visits throughout childhood. […] The Ortolani test and Barlow maneuver should be done at each exam. […] With an unstable, Ortolani positive hip, early treatment is required. Reduced hips are positioned in flexion and mild abduction to stimulate normal joint development, most commonly performed via the Pavlik harness, a dynamic brace which positions the thighs to allow and maintain hip reduction. […] Infants are followed bi-weekly for strap adjustment. Progress is monitored and reduction verified with subsequent US evaluations. […] Treatment success depends on the child’s age and the success of repositioning. Many cases treated in the first 6 months of life with a Pavlik harness recover and develop normally with no long-term problems.

• #9 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  11. Teach parents and the child to utilize devices or aids for mobility and ADL. Helps the safe use of aids and equipment and increased protection. […] Children with congenital hip dysplasia who do not receive proper treatment for their condition, or whose treatment is incorrect, may be at risk for hip dislocation or other hip injuries. This can lead to long-term complications and impaired physical mobility, which can have a significant impact on their overall quality of life. […] Assess infants up to 2 months of age for frank breech birth, cesarean birth, hipjoint laxity or dislocation (Ortolani or Barlow test), degree of dysplasia or dislocation, shortened limb on the affected side (telescoping), broadened perineum, asymmetry of the thigh and gluteal folds with an increased number of folds, and flattened buttocks. Provides information about the presence and degree of dysplasia; may be preluxation, subluxation, or dislocation (luxation) and involve a laxity of the capsule or an abnormal acetabulum; identification of the presence of the deformity at this age results in the highest success rate in complete correction.

• #10

  https://www.orthobullets.com/pediatrics/4118/developmental-dysplasia-of-the-hip-ddh

  Developmental Dysplasia of the Hip is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation of the hip secondary to capsular laxity and mechanical instability. […] Diagnosis can be confirmed with ultrasonography in the first 4 months and then with radiographs after femoral head ossification occurs (~ 4-6 months). […] Treatment varies from Pavlik bracing to surgical reduction and osteotomies depending on the age of the patient, underlying etiology, and the severity of dysplasia. […] Non-operative treatment includes abduction splinting/bracing (Pavlik harness) for infants 6 months old and with a reducible hip. […] Closed reduction and spica casting are indicated for children 6-18 months old who have failed Pavlik treatment. […] Operative options include open reduction and spica casting for those 18 months old or older, and open reduction with femoral osteotomy for children 2 years old with residual hip dysplasia.

• #11 Hip dysplasia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hip-dysplasia/diagnosis-treatment/drc-20350214

  During well-baby visits, healthcare professionals typically check for hip dysplasia by moving an infant’s legs into a variety of positions that help indicate whether the hip joint fits together well. […] If hip dysplasia is suspected, a hip ultrasound might be ordered to check the hip joint for signs of dysplasia. […] Infants are usually treated with a soft brace, called a Pavlik harness, that holds the ball portion of the joint firmly in its socket for several months. This helps the socket mold to the shape of the ball. […] In some cases, the healthcare professional needs to move the hip joint bones into the proper position and then hold them there for several months with a body cast called a spica cast. […] Hip dysplasia treatment depends on the age of the affected person and the extent of the hip damage.

• #12 Developmental dysplasia of the hip in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/developmental-dysplasia-of-the-hip-in-neonates

  The longer the hip is left in abnormal position the more the anatomy changes, developing abnormalities of the proximal femur and acetabulum. After 18 months, both bones may need surgical correction to provide joint congruity and stability. […] Since DDH can develop over time, all infants (both high and low risk) with normal newborn examinations should have their hips regularly re-examined during the first year of life. […] High-risk infants in whom examination is normal should have ultrasonography performed at about six to 12 weeks after birth or at six to eight weeks corrected age if born prematurely. […] There is no 'gold standard’ diagnostic test for DDH. The Ortolani and Barlow tests are widely used for screening. […] X-rays are unhelpful in assessment at birth as the femoral head is cartilaginous until six months of age.

• #13 Developmental Dysplasia of the Hip – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563157/

  Treatment of developmental dysplasia of the hip aims to provide an optimal environment for the normal growth of the femoral head and acetabulum. Therefore, a high suspicion index and routine surveillance are needed to detect DDH and prevent complications. Treatment modalities like abduction splinting, closed reduction, and open reduction are available to establish optimal contact between the femoral head and the acetabulum. […] The treatment of developmental dysplasia of the hip depends on the patient’s age and the severity of the dysplasia. In cases of minor hip instability (Barlow positive, Ortalani negative), spontaneous recovery occurs in 90% of cases within the first 2 weeks of life. […] Continued surveillance by the primary care practitioner during infancy improves detection and early referral. Pavlik harness corrects 95% of developmental dysplasia of the hip if applied before 6 months of age. Residual dysplasia may still occur even after appropriate treatment, necessitating annual follow-up until skeletal maturity is reached. […] Developmental dysplasia of the hip is the most common cause of early osteoarthritis in women younger than 40 years. Therefore, screening and identifying developmental dysplasia of the hip before 6 months of age should be the goal to prevent long-term complications.

• #14 Developmental Dysplasia of the Hip (DDH) – Seattle Children’s Hospital

  https://www.seattlechildrens.org/conditions/developmental-dysplasia-of-the-hip/

  Developmental dysplasia of the hip (DDH) is the name for a wide range of problems with the way a child’s hips form. […] We can successfully treat most infants and children who have DDH. For the best results, it is important to start treatment early. Early treatment with a harness or brace helps avoid the need for surgery. […] To treat DDH successfully, it is important to find the condition early. The most helpful type of treatment depends on how old your child is when DDH is found. […] All types of treatment have the same goal: putting the hip joint back in place and keeping it there. This kind of treatment is called reduction. […] If a Pavlik harness does not work for your child after a month or so, we may try a more rigid brace (fixed hip abduction brace like the Rhino Cruiser or Ilfeld brace).

• #15 Hip Dysplasia: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17903-hip-dysplasia

  Hip dysplasia is a health condition that happens when the bones in your hip joint dont fit together correctly. […] Healthcare providers sometimes refer to hip dysplasia that children are born with as congenital hip dysplasia or developmental dysplasia of the hip (DDH). These are all different names for the same condition. […] A healthcare provider will suggest treatments for hip dysplasia that relieve pain and protect your hip joint. The most common hip dysplasia treatments include: Wearing a brace: Babies may need to wear a brace or harness that holds their hips in place. This will keep their joints in proper alignment while their body grows and develops. Bracing is usually all your child will need to correct dysplasia, especially if they start treatment when theyre younger than 6 months old. Most babies need to wear a brace for a few months.

• #16 Developmental Dysplasia of the Hip (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/ddh.html

  Developmental dysplasia of the hip (DDH) is a problem with the way a baby’s hip joint forms. Sometimes the condition starts before the baby is born, and sometimes it happens after birth, as the child grows. It can affect one hip or both. […] Most infants treated for DDH develop into active, healthy kids and have no hip problems. […] A pediatric orthopedic surgeon (a specialist in children’s bone conditions) cares for babies and kids with DDH. The goal of care is to get the ball of the hip in the socket and keep it there, so the joint can grow normally. […] Treatment for babies younger than 6 months old usually is a brace. The brace used most often is a Pavlik harness. It has a shoulder harness that attaches to foot stirrups. It puts the baby’s legs into a position that guides the ball of the hip joint into the socket.

• #17 Hip Dysplasia

  https://www.massgeneral.org/orthopaedics/children/conditions-and-treatments/hip-dysplasia

  Developmental dysplasia of the hip is an abnormal formation of the hip joint in which the ball at the top of the thighbone is not stable in the socket. […] Developmental dysplasia of the hip (DDH) may occur during fetal development, at delivery, or after birth. […] Once the diagnosis if DDH has been made, the treatment will depend on the age of the child and the degree of instability. […] If the ultrasound shows that the hip is subluxating, dislocated, or that the acetabulum is shallow (decreased femoral head coverage), the initial treatment may consist of a Pavlik harness. […] The Pavlik harness is successful in approximately 90-95% of infants with hip dysplasia. […] The Pavlik harness is usually needed for approximately 6-12 weeks, as long as there is continued improvement seen on serial hip ultrasounds.

• #18 Developmental Dysplasia of the Hip (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/ddh.html

  Treatment with the Pavlik harness often lasts about 612 weeks. While wearing the harness, the baby has a checkup every 13 weeks with hip ultrasounds and exams. During the visit, the medical team can adjust the harness if needed. […] A child might need a closed reduction if: The harness was not successful at keeping the ball of the hip in the socket. […] A child might need surgery (an open reduction) if: The closed reduction was not successful at keeping the ball of the hip in the socket.

• #19 Planning Treatment for Children – International Hip Dysplasia Institute

  https://hipdysplasia.org/infant-child/planning-treatment-for-children/

  Once the harness is fitted properly, it is necessary to have follow-up visits every week or two to adjust the harness and check the progress of the reduction. […] Treatment with the Pavlik Harness should be successful within four weeks or another form of treatment is usually recommended. […] The most common treatment for this age group is for the surgeon to manipulate the hip back into the socket under general anesthesia and then apply a body cast called a spica cast to hold the hip in position for several months while it heals and becomes more stable. […] Anterior open reduction of the joint with additional bone surgery and ligament tightening as needed. […] A body cast is used for 6-8 weeks after surgery. […] Pelvic osteotomy is often performed to re-shape the socket. […] Reduction is rarely recommended in older children with completely dislocated hips because the bone changes are permanent by this age.

• #20 Developmental Dysplasia of the Hip (DDH) – Seattle Children’s Hospital

  https://www.seattlechildrens.org/conditions/developmental-dysplasia-of-the-hip/

  Developmental dysplasia of the hip (DDH) is the name for a wide range of problems with the way a child’s hips form. […] We can successfully treat most infants and children who have DDH. For the best results, it is important to start treatment early. Early treatment with a harness or brace helps avoid the need for surgery. […] To treat DDH successfully, it is important to find the condition early. The most helpful type of treatment depends on how old your child is when DDH is found. […] All types of treatment have the same goal: putting the hip joint back in place and keeping it there. This kind of treatment is called reduction. […] If a Pavlik harness does not work for your child after a month or so, we may try a more rigid brace (fixed hip abduction brace like the Rhino Cruiser or Ilfeld brace).

• #21

  https://www.orthobullets.com/pediatrics/4118/developmental-dysplasia-of-the-hip-ddh

  The goals of treatment are based on early concentric reduction to prevent future degeneration of the hip. […] Complications specific to Pavlik harness treatment include avascular necrosis (AVN), transient femoral nerve palsy, and Pavlik disease. […] Overall success rate of Pavlik harness treatment is 90%, dependent on age at initiation of treatment and time spent in the harness. […] If Pavlik harness fails, consider converting to a semi-rigid abduction brace with weekly ultrasounds for an additional 3-4 weeks before considering further intervention.

• #22 Developmental Dysplasia of the Hip (DDH) Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/1248135-treatment

  In patients older than 6 months, the success rate with a Pavlik harness is less than 50%; therefore, this therapy should not be used in these patients. […] Closed reduction is typically performed with the aid of arthrography, which is used to determine the adequacy of the reduction. […] Open reduction is the treatment of choice for DDH in children who are older than 2 years at the time of the initial diagnosis or in whom attempts at closed reduction have failed. […] When open reduction is performed, the patient wears a hip spica cast for 6-12 weeks, then is placed in an abduction orthosis.

• #23 Developmental dysplasia of the hip (DDH) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/developmental-dysplasia-hip-ddh

  If the harness and/or brace are not successful, a procedure under anesthesia may be needed to put the hip back into place manually, also known as a closed reduction. If successful, a custom molded body cast (called a spica cast) is put on the baby to hold the hip in place. […] If a closed reduction is not successful, the next line of treatment is surgery in the form of an open reduction, to reposition the ball within the socket.

• #24 Hip Dysplasia

  https://www.massgeneral.org/orthopaedics/children/conditions-and-treatments/hip-dysplasia

  If there is no improvement seen, the Pavlik harness will be discontinued, and it will be necessary to proceed with closed reduction and spica body casting (done in the operating room). […] The harness can be removed for bathing, and can be washed and dried if necessary. […] If there is no improvement in the hip dysplasia with the Pavlik harness, the baby will most likely require a closed reduction and spica casting in the operating room. […] If the hip dysplasia cannot be corrected with the Pavlik harness or closed reduction and casting, it may be necessary to proceed with open reduction and spica casting. […] Generally follow-up appointments occur at 6 months, 12 months, 2 years and 4-5 years.

• #25

  https://www.orthobullets.com/pediatrics/4118/developmental-dysplasia-of-the-hip-ddh

  Developmental Dysplasia of the Hip is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation of the hip secondary to capsular laxity and mechanical instability. […] Diagnosis can be confirmed with ultrasonography in the first 4 months and then with radiographs after femoral head ossification occurs (~ 4-6 months). […] Treatment varies from Pavlik bracing to surgical reduction and osteotomies depending on the age of the patient, underlying etiology, and the severity of dysplasia. […] Non-operative treatment includes abduction splinting/bracing (Pavlik harness) for infants 6 months old and with a reducible hip. […] Closed reduction and spica casting are indicated for children 6-18 months old who have failed Pavlik treatment. […] Operative options include open reduction and spica casting for those 18 months old or older, and open reduction with femoral osteotomy for children 2 years old with residual hip dysplasia.

• #26 Pediatric Developmental Dysplasia of the Hip (DDH) | Children’s Healthcare of Atlanta

  https://www.choa.org/medical-services/orthopedics/hip-program/developmental-dysplasia-of-the-hip

  Treatment for your child is based on: Age, Extent of hip dysplasia, Medical history, Tolerance to medicine, procedures and therapies. […] Treatment options may include: Pavlik harness: A tool for babies up to 6 months old, this harness keeps the hip in the right place while allowing your childs legs to move and is usually worn for at least six weeks. Its important for a doctor to monitor the hips as your child grows. The hips may not fully develop, requiring further treatment. […] Surgery: This option allows a doctor to manually put your childs hip in place. If the other methods are not successful, or if hip dysplasia is diagnosed after 6 months old, surgery and casting may be needed. […] Physical therapy: Participating in physical therapy allows your child to perform exercises and stretches with a specialist to help make the muscles around the hip stronger and help teach your child how to walk again.

• #27 Developmental dysplasia of the hip (DDH)

  https://www.rch.org.au/kidsinfo/fact_sheets/Developmental_dysplasia_of_the_hip_DDH/

  If splinting does not work, your child may need a procedure called a closed reduction. Closed reduction means the hip joint is repaired without surgery. The hip joint is moved into the correct position while your child is asleep under anaesthetic. […] Sometimes, when the above treatments do not work or DDH is diagnosed later than six months of age, your child may need open reduction surgery (when surgery is done through a cut in the body). […] After open reduction surgery (and sometimes after closed reduction surgery) your child will need a hip spica a plaster cast that covers your child’s body from the knees to the waist. Hip spicas may need to be worn for several months. […] Treatment may include a brace, a plaster cast called a hip spica, movement of the hip into position under anaesthetic, or surgery to the ligaments around the joint. […] If DDH is not treated, your child may develop a painless limp. Over time, painful arthritis will develop in the untreated hip joint.

• #28 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Congenital Hip Dysplasia Nursing Care Plans and Nursing Diagnosis […] In this nursing care plan guide for congenital hip dysplasia nursing diagnosis, well discuss the interventions, and management for this condition. Learn about interventions like orthopedic devices, physical therapy, and patient education that can improve hip development and manage symptoms such as pain and mobility issues. […] Nursing care planning goals for a child with congenital hip dysplasia include improving physical mobility, providing appropriate family and social support, providing patient and family education on self-care and safety, and avoiding complications (e.g., compartment syndrome and hip dislocation). […] The following are the nursing priorities for patients with congenital hip dysplasia: […] 1. Promote optimal hip development and stability

• #29 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Goals and expected outcomes may include: […] – The child will move self in bed with a traction bar; walk the length of the hallway and back twice a day. […] – The child will maintain his or her traction; the Pavlik harness is applied properly; the skin is free of irritation in the spica cast. […] – The child will maintain passage of soft, formed stool every 1 to 3 days without straining. […] – The parent will stay with the infant and renders social interaction. […] – The infant will respond positively to parental interaction. […] – The child will be included in family activities. […] Therapeutic interventions and nursing actions for patients with congenital hip dysplasia may include: […] 1. Assess muscle mass, strength, tone; ability to move, and activity level in performing ADL. Provides data about the condition and function of the musculoskeletal system.

• #30 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not properly form in infants and children. It can range from mild acetabular dysplasia to full dislocation of the femoral head. […] Treatment involves devices like Pavlik harnesses or hip spica casts to position the hip correctly as the child grows. Nursing management focuses on promoting mobility, preventing injury and infection, and providing education to parents on caring for orthotic devices. […] Nursing Assessment Assess for positive family history During the infant assessment process and routine nurturing activities, the nurse inspects the hips and extremities for any deviations from normal. Non ambulatory children with cerebral palsy or spina bifida should be assessed for evidence of hip problems as well.

• #31 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  2. Assess the sensory and motor function of extremities; the presence of surgical correction of musculoskeletal abnormalities. Provides data about conditions or treatments that affect mobility. […] 3. Assess activity restrictions, bed rest status, and imposed immobility by braces, casts, traction, and splints. Keep rest during acute stages to promote healing and restoration of health. […] 4. Allow all age-appropriate activities that promote mobility, and encourage the infant to crawl. Facilitates mobility based on the constraints of illness and provides an opportunity to vent frustration due to imposed immobility. […] 5. Discourage activity restrictions unless ordered; allow and assist if possible in performing daily activities; administer pain medication prior to the activity. Supports mobility and activity compatible with health and life; allows for independence and control for normal development.

• #32 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Maintain skin traction in the presence of abduction contracture in the infant up to 6 months of age and spica cast if applied following the traction; maintain skin traction for gradual reduction of the hip adductor and flexor muscles with a spica cast application for immobilization in child 6 to 10 months of age. Promotes hip abduction until stable; applies with a spica cast if unable to maintain stable reduction of the hip for 3 to 6 months; removal of the spica cast is followed by an abduction brace for protection. […] Provide instruction on spica cast care including support of cast when moving, removing crumbs and small articles that may get into the cast, petal cast edges, avoiding the insertion of anything into cast to scratch, cleaning cast when needed, allowing to dry completely, protect cast from soiling and dampness from elimination or bathing; neurologic and circulatory assessment every 2 hours for color, warmth, sensation, peripheral pulse, capillary refill; nausea and vomiting resulting from cast syndrome. Maintains safe, effective immobilization to guarantee the permanent stability of the hip with the child’s response to cast monitored for the cast syndrome as a result of tight spica cast compressing the superior mesenteric artery of the duodenum.

• #33 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  2. Ensure proper management of orthotic devices […] 3. Support appropriate developmental milestones […] 4. Provide psychosocial support […] 5. Educate and support patients and families […] 6. Collaborate with the healthcare team […] Nursing diagnoses provide a standardized method for recognizing, prioritizing, and addressing specific client needs and responses related to congenital hip dysplasia, including both actual and high-risk problems. They encompass the identification of current or potential health issues that can be effectively prevented or resolved through independent nursing interventions. Formulating nursing diagnoses becomes essential after conducting a thorough assessment to effectively address the patients current and potential health concerns related to congenital hip dysplasia. These diagnoses serve as a framework for developing and implementing personalized nursing interventions, aiming to optimize patient care.

• #34 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  6. Provide and apply harness and splint; use of aids including wheelchair, crutches, supportive reading, eating, and other aids for ADL as needed. Promotes autonomy and support in mobility and activities. […] 7. Keep body alignment during bed rest, do position changes every two (2) hours or as needed; provide a drawing for the child to follow for the position and area to lie in bed. Avoids contractures and physical deformity. […] 8. Encourage and assist the child in muscle-strengthening exercises and passive stretching exercises as appropriate. Conserves muscle strength or prepares for the use of mobility aids. […] 9. Facilitates rest with periods of mobility. Avoids fatigue and maintains energy. […] 10. Teach parents and the child about complications brought about by immobility. Promotes compliance with the program to maintain mobility and understanding of the effects of immobility.

• #35 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Nursing Diagnosis Impaired Physical Mobility related to musculoskeletal impairment of hip Ineffective tissue perfusion related to application of spica cast Disturbed body image related to unequal lower limbs Deficient Knowledge related to caring of child with pelvic harness and spica cast Constipation related to immobilitiy […] Nursing Goal To provide wholistic nursing care inorder to recover from the musculoskeletal deformities. To provide support for children and parents to promote the health of child. […] Nursing Intervention Promoting physical mobility of child Discourage activity restrictions unless ordered, allow and assist if possible in performing daily activities Provide and apply harness, splint; use of aids including wheelchair, crutches, supportive reading, eating, and other aids for activities of daily living as needed. Encourage and assist the child in muscle strengthening exercises

• #36 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Providing Skin Care Skin care is provided to prevent skin breakdown Check frequently (at least two to three times per day) for red areas under the straps and at skin folds. Gently massage healthy skin under the straps once a day to stimulate circulation. In general, avoid lotions and powders because they can cake and irritate the skin. Always place the diaper under the straps. […] Providing nutritious diet: The diet must contain adequate protein and calories that helps in normal growth and development of child. […] Preventing infection: Proper hand washing while caring child. Maintain clean environment. Maintain personal hygiene of baby. Use aseptic technique during invasive procedure. e.g surgery, IV access, dressing. […] Promoting growth and development of child Growth and development assessment of child must be done periodically. Assess child for early diagnosis of cases and help them recover. Involve child in age appropriate play therapy. Teach parents for routine immunization of child, nutrition, rest and sleep, exercise and home care. Help the parents to relieve anxiety by providing emotional support.

• #37 Musculoskeletal Disorders – Developmental Dysplasia of the Hip

  https://leveluprn.com/blogs/pediatric-nursing/42-musculoskeletal-disorders-developmental-dysplasia-hip?srsltid=AfmBOorpJiDYu-Sn9qv0R58WwE46D8kebii4jCPKpEiHxUHyPdPbpAmf

  Developmental dysplasia of the hip is dislocation or instability of the hip joint. With this disorder, there is abnormal development of the hip joint when the baby is in the uterus. And this results in misalignment of the femur and acetabulum. […] Treatment of DDH includes a Pavlik harness for infants under the age of six months, and then for children over the age of six months, surgery is typically required and a hip spica cast is placed for a period of time. […] A Pavlik harness keeps the baby’s legs apart and their legs turned outward. Kind of like a frog leg position. […] Family teaching for a Pavlik harness is definitely important to know in nursing school, and this information would lend itself well to a select all-that-applies type question. So a Pavlik harness needs to be worn for at least 23 hours a day and for at least six weeks. It’s important that families assess their baby’s skin several times a day and gently massage their baby’s skin under the straps. Lotions and powders should be avoided, and then the baby should wear an undershirt and socks under the harness. The baby’s diaper should be placed under the straps, and it’s important that families understand that they should not adjust the harness themselves. There will be follow-up appointments with the provider every one to two weeks for evaluation and adjustment of the straps.

• #38 Developmental dysplasia of the hip | Children’s Wisconsin

  https://childrenswi.org/medical-care/orthopedics/conditions/developmental-dysplasia-of-the-hip

  DDH is a condition in which the relationship between the hip socket and femoral head is abnormal. […] The goal of treatment is to maintain the femoral head into the socket of the hip so that the hip can develop normally. […] Specific treatment for DDH will be determined by your baby’s physician and orthopedic specialist based on: Your baby’s age, overall health, and medical history; The extent of the condition; Expectations for the course of the condition; Your opinion or preference. […] The Pavlik harness is used on babies up to 6 months of age to hold the hip in place, while allowing the legs to move a little. […] If the hip continues to be partially or completely dislocated, often casting or surgery may be required to help relocate the hip. […] A short leg hip spica cast is applied from the chest to the thighs or knees. This type of cast is used to hold the hip in place after surgery to allow healing. […] Contact your baby’s physician or healthcare provider if your baby develops one or more of the following symptoms: Fever, Increased pain, Increased swelling above or below the cast, Drainage or foul odor from the cast, Cool or cold toes.

• #39 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Providing Skin Care Skin care is provided to prevent skin breakdown Check frequently (at least two to three times per day) for red areas under the straps and at skin folds. Gently massage healthy skin under the straps once a day to stimulate circulation. In general, avoid lotions and powders because they can cake and irritate the skin. Always place the diaper under the straps. […] Providing nutritious diet: The diet must contain adequate protein and calories that helps in normal growth and development of child. […] Preventing infection: Proper hand washing while caring child. Maintain clean environment. Maintain personal hygiene of baby. Use aseptic technique during invasive procedure. e.g surgery, IV access, dressing. […] Promoting growth and development of child Growth and development assessment of child must be done periodically. Assess child for early diagnosis of cases and help them recover. Involve child in age appropriate play therapy. Teach parents for routine immunization of child, nutrition, rest and sleep, exercise and home care. Help the parents to relieve anxiety by providing emotional support.

• #40 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Educate parents about the type and extent of deformity and cause and treatment plan for correction and prognosis by reinforcing physician information; inform of suggested surgical reduction in an older child or if obstruction of joint development by soft tissue is present in the young child. Provides information about the deformity, its classification, and pharmacological or surgical regimen that is determined based on age and severity of the deformity. […] Guarantees correct cast care for immobilization of the hip following a surgical hip reduction; traction or surgical correction may be used for acetabulum reduction or reconstruction.

• #41 Musculoskeletal Disorders – Developmental Dysplasia of the Hip

  https://leveluprn.com/blogs/pediatric-nursing/42-musculoskeletal-disorders-developmental-dysplasia-hip?srsltid=AfmBOorpJiDYu-Sn9qv0R58WwE46D8kebii4jCPKpEiHxUHyPdPbpAmf

  Developmental dysplasia of the hip is dislocation or instability of the hip joint. With this disorder, there is abnormal development of the hip joint when the baby is in the uterus. And this results in misalignment of the femur and acetabulum. […] Treatment of DDH includes a Pavlik harness for infants under the age of six months, and then for children over the age of six months, surgery is typically required and a hip spica cast is placed for a period of time. […] A Pavlik harness keeps the baby’s legs apart and their legs turned outward. Kind of like a frog leg position. […] Family teaching for a Pavlik harness is definitely important to know in nursing school, and this information would lend itself well to a select all-that-applies type question. So a Pavlik harness needs to be worn for at least 23 hours a day and for at least six weeks. It’s important that families assess their baby’s skin several times a day and gently massage their baby’s skin under the straps. Lotions and powders should be avoided, and then the baby should wear an undershirt and socks under the harness. The baby’s diaper should be placed under the straps, and it’s important that families understand that they should not adjust the harness themselves. There will be follow-up appointments with the provider every one to two weeks for evaluation and adjustment of the straps.

• #42 Developmental Dysplasia of the Hip (DDH) – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/developmental-dislocation-dysplasia-of-the-hip-ddh/

  Parents play an essential role in ensuring the harness is effective. Your doctor and healthcare team will teach you how to safely perform daily care tasks, such as diapering, bathing, feeding, and dressing. It is very important to attend all of your baby’s scheduled clinic visits so the doctor can check the hip and the fit of the Pavlik harness. […] In many children with DDH, a body cast and/or brace is required to keep the hip bone in the joint during healing. The cast may be needed for 2 to 3 months. Your child’s doctor may change the cast during this time period. […] If diagnosed early and treated successfully, children are able to develop a normal hip joint and should have no limitation in function. Left untreated, DDH can lead to pain and osteoarthritis by early adulthood. It may produce a difference in leg length or decreased agility.

• #43 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Maintain skin traction in the presence of abduction contracture in the infant up to 6 months of age and spica cast if applied following the traction; maintain skin traction for gradual reduction of the hip adductor and flexor muscles with a spica cast application for immobilization in child 6 to 10 months of age. Promotes hip abduction until stable; applies with a spica cast if unable to maintain stable reduction of the hip for 3 to 6 months; removal of the spica cast is followed by an abduction brace for protection. […] Provide instruction on spica cast care including support of cast when moving, removing crumbs and small articles that may get into the cast, petal cast edges, avoiding the insertion of anything into cast to scratch, cleaning cast when needed, allowing to dry completely, protect cast from soiling and dampness from elimination or bathing; neurologic and circulatory assessment every 2 hours for color, warmth, sensation, peripheral pulse, capillary refill; nausea and vomiting resulting from cast syndrome. Maintains safe, effective immobilization to guarantee the permanent stability of the hip with the child’s response to cast monitored for the cast syndrome as a result of tight spica cast compressing the superior mesenteric artery of the duodenum.

• #44 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  6. Provide and apply harness and splint; use of aids including wheelchair, crutches, supportive reading, eating, and other aids for ADL as needed. Promotes autonomy and support in mobility and activities. […] 7. Keep body alignment during bed rest, do position changes every two (2) hours or as needed; provide a drawing for the child to follow for the position and area to lie in bed. Avoids contractures and physical deformity. […] 8. Encourage and assist the child in muscle-strengthening exercises and passive stretching exercises as appropriate. Conserves muscle strength or prepares for the use of mobility aids. […] 9. Facilitates rest with periods of mobility. Avoids fatigue and maintains energy. […] 10. Teach parents and the child about complications brought about by immobility. Promotes compliance with the program to maintain mobility and understanding of the effects of immobility.

• #45 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Preventing Constipation Provide plenty of fluids and diet rich in fibre. Encourage for active exercise. Do not restrict the activities of child unless recommended. Give laxatives if severe constipation occurs […] Increasing social interaction with child Provide family centred care. It is important for nurses, parents, and other caregivers to understand that children in corrective devices need to be involved in all the activities of any child in the same age-group. […] Decrease caregiver burden Manage the time of treatment and procedure to decrease burden of parents. Inform the parents about physical facilities available for child and parents. Allow the visitors to take time for caring ownself. […] Preventing injury The child must be provided with orthotic devices such as crutches, calipers etc for balance while mobilization. Use side rails in bed for small children. Teach child and parents about safety precautions to prevent injury.

• #46 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Increasing tissue perfusion Asses the sign of decreased peripheral tissue perfusion; such as numbness, bluish discoloration, pain, pallor, cold extremities for a child wearing spica cast. Release the cast and facilitate for the appropriate circulation of blood. Teach patient to identify the impaired peripheral circulation. […] Maintaining body image Help the patient for compliance of treatment. It includes wearing pelvic harness, spica cast, reduction of the affected part. Show child the patient with similar condition and help to build confidence. […] Improve knowledge of child and parents It is important that parents understand the correct use of the device, which may or may not allow for its removal during bathing. Removing the harness is determined individually on the basis of the providers recommendations, the degree of hip instability, and the familys level of understanding.

• #47 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Goals and expected outcomes may include: […] – The child will move self in bed with a traction bar; walk the length of the hallway and back twice a day. […] – The child will maintain his or her traction; the Pavlik harness is applied properly; the skin is free of irritation in the spica cast. […] – The child will maintain passage of soft, formed stool every 1 to 3 days without straining. […] – The parent will stay with the infant and renders social interaction. […] – The infant will respond positively to parental interaction. […] – The child will be included in family activities. […] Therapeutic interventions and nursing actions for patients with congenital hip dysplasia may include: […] 1. Assess muscle mass, strength, tone; ability to move, and activity level in performing ADL. Provides data about the condition and function of the musculoskeletal system.

• #48 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Preventing Constipation Provide plenty of fluids and diet rich in fibre. Encourage for active exercise. Do not restrict the activities of child unless recommended. Give laxatives if severe constipation occurs […] Increasing social interaction with child Provide family centred care. It is important for nurses, parents, and other caregivers to understand that children in corrective devices need to be involved in all the activities of any child in the same age-group. […] Decrease caregiver burden Manage the time of treatment and procedure to decrease burden of parents. Inform the parents about physical facilities available for child and parents. Allow the visitors to take time for caring ownself. […] Preventing injury The child must be provided with orthotic devices such as crutches, calipers etc for balance while mobilization. Use side rails in bed for small children. Teach child and parents about safety precautions to prevent injury.

• #49 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  2. Ensure proper management of orthotic devices […] 3. Support appropriate developmental milestones […] 4. Provide psychosocial support […] 5. Educate and support patients and families […] 6. Collaborate with the healthcare team […] Nursing diagnoses provide a standardized method for recognizing, prioritizing, and addressing specific client needs and responses related to congenital hip dysplasia, including both actual and high-risk problems. They encompass the identification of current or potential health issues that can be effectively prevented or resolved through independent nursing interventions. Formulating nursing diagnoses becomes essential after conducting a thorough assessment to effectively address the patients current and potential health concerns related to congenital hip dysplasia. These diagnoses serve as a framework for developing and implementing personalized nursing interventions, aiming to optimize patient care.

• #50 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Nursing Diagnosis Impaired Physical Mobility related to musculoskeletal impairment of hip Ineffective tissue perfusion related to application of spica cast Disturbed body image related to unequal lower limbs Deficient Knowledge related to caring of child with pelvic harness and spica cast Constipation related to immobilitiy […] Nursing Goal To provide wholistic nursing care inorder to recover from the musculoskeletal deformities. To provide support for children and parents to promote the health of child. […] Nursing Intervention Promoting physical mobility of child Discourage activity restrictions unless ordered, allow and assist if possible in performing daily activities Provide and apply harness, splint; use of aids including wheelchair, crutches, supportive reading, eating, and other aids for activities of daily living as needed. Encourage and assist the child in muscle strengthening exercises

• #51 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Nursing Diagnosis Impaired Physical Mobility related to musculoskeletal impairment of hip Ineffective tissue perfusion related to application of spica cast Disturbed body image related to unequal lower limbs Deficient Knowledge related to caring of child with pelvic harness and spica cast Constipation related to immobilitiy […] Nursing Goal To provide wholistic nursing care inorder to recover from the musculoskeletal deformities. To provide support for children and parents to promote the health of child. […] Nursing Intervention Promoting physical mobility of child Discourage activity restrictions unless ordered, allow and assist if possible in performing daily activities Provide and apply harness, splint; use of aids including wheelchair, crutches, supportive reading, eating, and other aids for activities of daily living as needed. Encourage and assist the child in muscle strengthening exercises

• #52 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Congenital Hip Dysplasia Nursing Care Plans and Nursing Diagnosis […] In this nursing care plan guide for congenital hip dysplasia nursing diagnosis, well discuss the interventions, and management for this condition. Learn about interventions like orthopedic devices, physical therapy, and patient education that can improve hip development and manage symptoms such as pain and mobility issues. […] Nursing care planning goals for a child with congenital hip dysplasia include improving physical mobility, providing appropriate family and social support, providing patient and family education on self-care and safety, and avoiding complications (e.g., compartment syndrome and hip dislocation). […] The following are the nursing priorities for patients with congenital hip dysplasia: […] 1. Promote optimal hip development and stability

• #53 Developmental dysplasia hip | PPT

  https://www.slideshare.net/slideshow/developmental-dysplasia-hip-238268502/238268502

  Nursing Diagnosis Impaired Physical Mobility related to musculoskeletal impairment of hip Ineffective tissue perfusion related to application of spica cast Disturbed body image related to unequal lower limbs Deficient Knowledge related to caring of child with pelvic harness and spica cast Constipation related to immobilitiy […] Nursing Goal To provide wholistic nursing care inorder to recover from the musculoskeletal deformities. To provide support for children and parents to promote the health of child. […] Nursing Intervention Promoting physical mobility of child Discourage activity restrictions unless ordered, allow and assist if possible in performing daily activities Provide and apply harness, splint; use of aids including wheelchair, crutches, supportive reading, eating, and other aids for activities of daily living as needed. Encourage and assist the child in muscle strengthening exercises

• #54 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  Congenital Hip Dysplasia Nursing Care Plans and Nursing Diagnosis […] In this nursing care plan guide for congenital hip dysplasia nursing diagnosis, well discuss the interventions, and management for this condition. Learn about interventions like orthopedic devices, physical therapy, and patient education that can improve hip development and manage symptoms such as pain and mobility issues. […] Nursing care planning goals for a child with congenital hip dysplasia include improving physical mobility, providing appropriate family and social support, providing patient and family education on self-care and safety, and avoiding complications (e.g., compartment syndrome and hip dislocation). […] The following are the nursing priorities for patients with congenital hip dysplasia: […] 1. Promote optimal hip development and stability

• #55 Developmental Dysplasia of the Hip (DDH): Etiology, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10488138/

  This review describes the epidemiology, etiopathogenesis, and diagnosis of DDH and summarizes the current trends in managing recurrent AD. […] The aim of DDH treatment depends on the patient’s age at the time of diagnosis and requires concentric reduction of the femoral head into the acetabulum. […] Patients should ideally be diagnosed and managed during infancy. […] The Pavlik harness had a 95% success rate in cases of AD or hip subluxation and an 80% success rate in cases of hip dislocation. […] For children who have failed Pavlik harness treatment, a closed or open reduction is recommended. […] Surgery is usually required to reconstruct the acetabulum and the femur, and the release of periarticular soft tissues is usually necessary for older children. […] Pelvic osteotomy facilitates the process by increasing the cover of the femoral head on the acetabular side.

• #56 Hip Dysplasia

  https://www.massgeneral.org/orthopaedics/children/conditions-and-treatments/hip-dysplasia

  Developmental dysplasia of the hip is an abnormal formation of the hip joint in which the ball at the top of the thighbone is not stable in the socket. […] Developmental dysplasia of the hip (DDH) may occur during fetal development, at delivery, or after birth. […] Once the diagnosis if DDH has been made, the treatment will depend on the age of the child and the degree of instability. […] If the ultrasound shows that the hip is subluxating, dislocated, or that the acetabulum is shallow (decreased femoral head coverage), the initial treatment may consist of a Pavlik harness. […] The Pavlik harness is successful in approximately 90-95% of infants with hip dysplasia. […] The Pavlik harness is usually needed for approximately 6-12 weeks, as long as there is continued improvement seen on serial hip ultrasounds.

• #57 Developmental Dysplasia of the Hip (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/ddh.html

  Developmental dysplasia of the hip (DDH) is a problem with the way a baby’s hip joint forms. Sometimes the condition starts before the baby is born, and sometimes it happens after birth, as the child grows. It can affect one hip or both. […] Most infants treated for DDH develop into active, healthy kids and have no hip problems. […] A pediatric orthopedic surgeon (a specialist in children’s bone conditions) cares for babies and kids with DDH. The goal of care is to get the ball of the hip in the socket and keep it there, so the joint can grow normally. […] Treatment for babies younger than 6 months old usually is a brace. The brace used most often is a Pavlik harness. It has a shoulder harness that attaches to foot stirrups. It puts the baby’s legs into a position that guides the ball of the hip joint into the socket.

• #58 Developmental Dysplasia of the Hip | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/d/dysplasia-hip

  With all of these treatments, children usually dont require rehabilitation afterward. […] In general, the earlier a child is treated for hip dysplasia, the less work the hip needs later in life. […] For children who use a Pavlik harness or undergo a successful closed reduction, most of the time no other treatments are needed afterward. […] For children who need an open reduction, their hips are never quite normal. They may notice problems with their hips as they grow. Chances are higher that these children may need a total hip replacement when theyre older. […] If DDH is left untreated, it can lead to pain and arthritis in early adulthood. Even those who have treatment sometimes have hip deformity and arthritis later in life.

• #59 Developmental dysplasia of the hip (DDH) | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/developmental-dysplasia-of-the-hip-ddh

  Developmental dysplasia of the hip, or DDH, means that the hip joint of a newborn baby is dislocated or prone to dislocation. […] Treatment includes special harnesses, or operations and casts, depending on the age of the child at diagnosis. […] A baby born with a dislocated hip can be successfully treated with a Pavlik harness. This device holds the joint in place while the baby’s skeleton grows and matures. […] In some babies, the ligaments around the hip joint are loose, which in most circumstances, corrects during the first few months of life. […] When wrapping your baby, always remember to leave enough room in the wrap for the legs to move freely. […] If a baby is diagnosed with a dislocated hip when they are six months old or more, then an anaesthetic will be required before the hip is manipulated into its proper position. An operation may also be needed. […] Most babies born with successfully treated DDH don’t have any hip problems in later life. However, some may develop arthritis in the affected joint in their later years.

• #60 Developmental Dysplasia of the Hip – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563157/

  Treatment of developmental dysplasia of the hip aims to provide an optimal environment for the normal growth of the femoral head and acetabulum. Therefore, a high suspicion index and routine surveillance are needed to detect DDH and prevent complications. Treatment modalities like abduction splinting, closed reduction, and open reduction are available to establish optimal contact between the femoral head and the acetabulum. […] The treatment of developmental dysplasia of the hip depends on the patient’s age and the severity of the dysplasia. In cases of minor hip instability (Barlow positive, Ortalani negative), spontaneous recovery occurs in 90% of cases within the first 2 weeks of life. […] Continued surveillance by the primary care practitioner during infancy improves detection and early referral. Pavlik harness corrects 95% of developmental dysplasia of the hip if applied before 6 months of age. Residual dysplasia may still occur even after appropriate treatment, necessitating annual follow-up until skeletal maturity is reached. […] Developmental dysplasia of the hip is the most common cause of early osteoarthritis in women younger than 40 years. Therefore, screening and identifying developmental dysplasia of the hip before 6 months of age should be the goal to prevent long-term complications.

• #61 Hip Dysplasia

  https://www.massgeneral.org/orthopaedics/children/conditions-and-treatments/hip-dysplasia

  If there is no improvement seen, the Pavlik harness will be discontinued, and it will be necessary to proceed with closed reduction and spica body casting (done in the operating room). […] The harness can be removed for bathing, and can be washed and dried if necessary. […] If there is no improvement in the hip dysplasia with the Pavlik harness, the baby will most likely require a closed reduction and spica casting in the operating room. […] If the hip dysplasia cannot be corrected with the Pavlik harness or closed reduction and casting, it may be necessary to proceed with open reduction and spica casting. […] Generally follow-up appointments occur at 6 months, 12 months, 2 years and 4-5 years.

• #62

  https://journals.lww.com/10.1097/NOR.0000000000000178

  Families, especially mothers, experience problems providing home care after their child’s surgery for developmental dysplasia of the hip (DDH). […] Nearly all of the parents (97%) had physical (96.9%), psychological (65.6%), and social (75.0%) problems in addition to child care problems. […] We recommend preparing a comprehensive discharge-training package for parents after their child’s DDH surgery, supplementing home care instructions with visual training materials, and providing telephone counseling to parents after discharge.

• #63 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/e3c3833f547486915b8e6413512eec9d

  The child in a Pavlik harness benefits from as much motion in the hip as possible – while still keeping the hip reduced. Motion allows for nutrition of the developing bone and cartilage inside the hip joint. The therapist will review positions to avoid such as sidelying with the top leg down toward the other leg past the midline. The harness must be used continuously until the hip is stable. Use may be gradually decreased to just nighttime wear before finally stopping. […] The child who has surgery will not be able to walk afterwards because of the spica cast. A special hole is cut open to allow the older child to go to the bathroom. Younger children remain in diapers. Your physical therapist will help the family with any special equipment needed for daily tasks and transportation. Special tips for positioning and handling will be reviewed as well. […] Physical and occupational therapy is important during the postoperative period in the cast. Opportunities to move and develop gross motor skills are limited. The therapist will closely monitor overall gross and fine motor skills normally occurring during this time.

• #64

  https://journals.lww.com/10.1097/NOR.0000000000000178

  Families, especially mothers, experience problems providing home care after their child’s surgery for developmental dysplasia of the hip (DDH). […] Nearly all of the parents (97%) had physical (96.9%), psychological (65.6%), and social (75.0%) problems in addition to child care problems. […] We recommend preparing a comprehensive discharge-training package for parents after their child’s DDH surgery, supplementing home care instructions with visual training materials, and providing telephone counseling to parents after discharge.

• #65 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  2. Ensure proper management of orthotic devices […] 3. Support appropriate developmental milestones […] 4. Provide psychosocial support […] 5. Educate and support patients and families […] 6. Collaborate with the healthcare team […] Nursing diagnoses provide a standardized method for recognizing, prioritizing, and addressing specific client needs and responses related to congenital hip dysplasia, including both actual and high-risk problems. They encompass the identification of current or potential health issues that can be effectively prevented or resolved through independent nursing interventions. Formulating nursing diagnoses becomes essential after conducting a thorough assessment to effectively address the patients current and potential health concerns related to congenital hip dysplasia. These diagnoses serve as a framework for developing and implementing personalized nursing interventions, aiming to optimize patient care.

• #66 Developmental Dysplasia of the Hip (DDH) – Seattle Children’s Hospital

  https://www.seattlechildrens.org/conditions/developmental-dysplasia-of-the-hip/

  At Seattle Children’s Orthopedics and Sports Medicine, we have a system to help make sure babies referred to us for severe dysplasia or a dislocated hip get care soon. This improves the chance that a harness or brace will work and they won’t need surgery. […] After surgery, your child will wear a spica cast on their hips and legs. The length of time in the cast depends on the child. […] Physical therapy is an important part of recovery after hip surgery. […] Our experts have the knowledge, training and skills to diagnose and treat hip dysplasia and related issues that your child might have at any age. […] Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options. We support you in making choices that are right for your family.

• #67 Developmental Dysplasia of the Hip (DDH)

  https://www.gillettechildrens.org/conditions-care/developmental-dysplasia-of-the-hip-ddh

  Developmental Hip Dysplasia (DDH) occurs in approximately one in 1,000 births. The earlier Developmental Hip Dysplasia is discovered and treated, the greater your child’s chances for a successful correction. If left untreated, Developmental Hip Dysplasia can lead to walking abnormalities, a limb-length difference, early arthritis, or hip pain. […] If your child has DDH, it’s important to try and resolve hip issues early in life. There are several types of treatment to correct hip dysplasia. Treatment depends on the child’s age and the severity of DDH. […] The Gillette Children’s Hip Preservation program with experienced orthopedic team offers comprehensive treatment for hip dysplasia, including: […] An integrated team will help you navigate the services your child needs including treatment of conditions associated with DDH, such as clubfoot, gait abnormalities, a limb length difference, early arthritis or hip pain. It’s important to have hips examined by a skilled medical team, including a pediatric ultrasonographer.

• #68 Developmental Dysplasia of the Hip (DDH) – Seattle Children’s Hospital

  https://www.seattlechildrens.org/conditions/developmental-dysplasia-of-the-hip/

  At Seattle Children’s Orthopedics and Sports Medicine, we have a system to help make sure babies referred to us for severe dysplasia or a dislocated hip get care soon. This improves the chance that a harness or brace will work and they won’t need surgery. […] After surgery, your child will wear a spica cast on their hips and legs. The length of time in the cast depends on the child. […] Physical therapy is an important part of recovery after hip surgery. […] Our experts have the knowledge, training and skills to diagnose and treat hip dysplasia and related issues that your child might have at any age. […] Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options. We support you in making choices that are right for your family.

• #69 4 Congenital Hip Dysplasia Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/congenital-hip-dysplasia-nursing-care-plans/

  2. Ensure proper management of orthotic devices […] 3. Support appropriate developmental milestones […] 4. Provide psychosocial support […] 5. Educate and support patients and families […] 6. Collaborate with the healthcare team […] Nursing diagnoses provide a standardized method for recognizing, prioritizing, and addressing specific client needs and responses related to congenital hip dysplasia, including both actual and high-risk problems. They encompass the identification of current or potential health issues that can be effectively prevented or resolved through independent nursing interventions. Formulating nursing diagnoses becomes essential after conducting a thorough assessment to effectively address the patients current and potential health concerns related to congenital hip dysplasia. These diagnoses serve as a framework for developing and implementing personalized nursing interventions, aiming to optimize patient care.

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