Developmental Dysplasia of the Hip: CA RN Care

Developmental dysplasia of the hip (DDH) describes a spectrum in which the femoral head and acetabulum have not developed a stable, congruent relationship. The femoral head may be loose within a shallow socket, partly displaced, readily dislocatable or fully dislocated. DDH may be present at birth or become apparent later. Normal acetabular development depends on the femoral head remaining centred in the socket while cartilage and bone grow. When the head is not centred, the socket can remain shallow and stability can worsen. The child may later develop a leg-length difference, limp, toe walking, waddling gait, pain or early arthritis. Early identification and a stable reduction give the developing hip the best opportunity to mature. DDH is a structural disorder. No laboratory test diagnoses it, and no medication corrects alignment. Diagnosis rests on history, trained physical examination and age-appropriate imaging. The RN assesses and documents findings, protects prescribed positioning, supports the family and monitors treatment complications; the physician or nurse practitioner (NP) and pediatric orthopaedic team diagnose and select treatment.