DDH is a deformity of the hip that can manifest in a few different ways. In Evie's case, her hip sockets are both shallow (the right one much more so - technically she does not have DDH in the left hip). Due to the shallow socket, the "ball" part of the femur (which at this point is mostly still cartilage) doesn't stay in the socket easily. Evie's right femur is totally dislocated from the hip socket.
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| You can see that the right hip (on the left in this picture) is much further out and higher than the left hip. The little white spots you see above the femur are where the bone is developing instead of the cartilage. |
Treatment before six months of age is usually a brace or harness. When I was born, I was diagnosed with mild hip dysplasia in both hips and wore a brace for four weeks. One of my cousins was just triple diapered for the first few weeks of her life and that took care of it. Post six months of age, most kids don't respond to the harness, so a surgery plus cast is the normal treatment.
The surgery can go one of two ways. The simpler procedure is when the hip is easily maneuvered back into place - that is called a closed reduction. So all they do is put the baby under general anesthesia, inject a dye so that they can see the cartilage of the ball and socket, put it back in place, and cast the torso to the legs. An open reduction is performed when the hip can't go back or won't stay easily - so they make a small incision and do what they need to do to create a space for the femur in the acetabulum (the socket). Sometimes this means clearing out fat or cartilage in the socket, or cutting ligaments or tendons that are pulling the hip in the wrong direction. Then they still cast the baby in a spica cast (the full body cast).
Most of the time, from what I have read, these treatments take care of the hip problems almost completely as long as they are done early enough. It is unlikely that a baby of Evie's age will need follow-up surgeries, although as with any medical issues, you never can know what will go wrong or right.
