This paper examines nursing care and clinical considerations for infants and children with developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip. It covers the condition's prevalence, suspected causes, diagnostic indicators, and a range of treatment options from the Pavlik Harness to surgical intervention. Special attention is given to the nurse's role at each stage of care, including preoperative evaluation, intraoperative support, postoperative monitoring, and family education. The paper emphasizes that early detection and prompt treatment significantly improve outcomes, and that nursing professionals are central to guiding families through diagnosis, treatment, and recovery.
The paper demonstrates applied clinical synthesis: it draws on medical definitions, epidemiology, and treatment evidence to directly inform nursing practice recommendations. Rather than simply describing the condition, the author consistently connects each clinical fact (e.g., the harness must stay on during bathing) to a specific nursing action or family-education goal. This technique — moving from "what is it" to "what does the nurse do about it" — is characteristic of strong nursing care papers.
The paper opens with a definition and epidemiology of DDH, then proceeds through causes and diagnostic signs, treatment goals, and general nursing considerations. The final two sections form a detailed walkthrough of perioperative nursing, covering preoperative evaluation, intraoperative roles, and postoperative monitoring through to discharge. The conclusion reinforces the nurse's central role and the importance of early detection.
Hip dysplasia occurs quite commonly in infants and children around the world. There are special considerations nurses should apply when caring for these patients, including recognizing the early symptoms of hip dysplasia and fully understanding the treatment necessary to help families cope with the condition. Treating and diagnosing children is often much more difficult than working with older patients who can communicate more effectively, so the nurse must be patient, observant, and highly knowledgeable about the disease, its indicators, and its treatment.
Hip dysplasia in infants and children was formerly known by two terms: developmental dysplasia of the hip (DDH) or congenital dislocation of the hip (CDH). Today, most professionals use the term DDH. Hip dysplasia occurs when the head of the femur (thigh bone) does not fit correctly into the pelvis, creating a hip joint that does not properly align. The condition can range from quite mild to extremely severe. In some cases the femur is only slightly out of position; in others it may be severely dislocated or fail to meet the acetabulum at all. The condition can be present at birth or can develop as the baby grows. It may affect one or both hips. Sometimes it is apparent at birth; other times it does not become evident until the baby begins to walk. For reasons not yet fully understood, the condition appears to occur more frequently in girls than in boys ("Developmental," 2004). It is also more prevalent in firstborn children. DDH occurs in approximately four out of every 1,000 births and is notably more common among Lapps and Native Americans ("Hip," 2004).
An exact cause has not been identified, but many healthcare professionals believe several factors may contribute to the condition. These include: certain hormones that cause the baby's hip joint to be unusually loose; genetic links suggesting DDH is passed down in families; breech positioning in the uterus before birth; and swaddling practices that keep a baby's hips in a straight position ("Developmental," 2004). Some researchers firmly believe the condition originates exclusively in the womb (D'Alessandro and Huth, 2002).
The condition is sometimes evident at birth, but the signs often do not appear until the baby is older. Routine well-baby check-ups are frequently the first opportunity to detect the condition. Common indicators include: extra skin folds or wrinkles on the thigh beneath the child's buttocks; reduced range of motion in the affected hip compared to the other; one leg appearing shorter than the other when the child lies flat on their back; a noticeable "waddling" gait or a tendency to lean toward the affected side; and audible or palpable "pops" or "clicks" in the baby's hip during specific movement tests ("Developmental," 2004).
To confirm the diagnosis, a physician may order an MRI, ultrasound, CT scan, or X-rays. Research has shown that ultrasound provides a more accurate diagnosis of DDH than other imaging modalities ("Hip," 2004). Treatment options include surgery, traction, or the use of a splint known as a Pavlik Harness, which holds the hips in the correct position. Older children may require a spica, or lower-body cast. The choice of treatment is based on the severity of the condition and the age of the child.
Treatment should begin as soon as the condition is identified. The ultimate goal is to align the bones correctly. If DDH is not treated early and effectively, the child may experience ongoing hip problems throughout their life, and the condition frequently leads to debilitating arthritis in adulthood. Notably, research has shown that some children born with DDH will simply outgrow the condition without any intervention (Berant, 1999).
You’re 39% through this paper. Sign up to read the remaining 3 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.