Understanding Redislocation in DDH_ What You Need to Know

1. Understanding Redislocation in DDH: What You Need to Know Developmental Dysplasia of the Hip (DDH) is a condition in which a child’s hip joint doesn’t develop properly — the “ball” (femoral head) may not sit securely in the “socket” (acetabulum). In some treated cases, after initial correction, there is a risk of redislocation, which means the hip may slip out of place again. Why Does Redislocation Happen? Several factors can contribute to a re-dislocated hip in DDH: ● Soft tissue interposition: Sometimes, tissues like ligaments or loose capsules get in the way, preventing a stable reduction. ● Unstable reduction: The hip may appear reduced (in place) during treatment, but instability remains.

2. ● Inadequate immobilisation: After a closed or open reduction, if immobilisation (via a cast, for example) isn’t maintained properly, the joint may dislocate again. ● Postoperative care issues: Poor follow-up or suboptimal positioning during cast therapy increase risk. ● Underlying risk factors: Factors like breech birth, family history, or failed brace therapy may make some hips more prone to complications. Signs & Symptoms: How to Spot a Redislocation Parents and caregivers should be vigilant about signs that suggest a hip has re-dislocated, especially after treatment: ● A sudden “clunk” or “click” when the hip is moved. ● Reduced range of motion or asymmetry in leg length or skin folds. ● In older children, walking differences like a limp or a waddling gait may re-emerge. ● Pain, stiffness, or discomfort in the hip joint. Tips to Prevent & Manage Redislocation Here are some practical tips and strategies for reducing the chance of redislocation and managing it effectively: 1. Ensure proper immobilisation After reduction (closed or open), using a well-fitted spica cast (or other immobilisation) is vital. Regular follow-up with the orthopaedic team ensures that casting is maintained correctly. 2. Stick to follow-up schedules Frequent imaging (ultrasound or X-ray) and check-ups help monitor hip stability and detect early signs of re-dislocation. 3. Be careful with positioning When handling your child — during diaper changes, bathing, or swaddling — ensure the hip is in a safe, stable position (usually slight flexion and abduction). According to guidelines, improper swaddling (tight, legs pressed

3. together) can worsen instability. 4. Strengthen supporting muscles Once immobilisation is over and with your surgeon’s guidance, pediatric physiotherapy can help strengthen the muscles around the hip and improve joint stability. 5. Know the risk factors Understanding risk factors helps: children born in breech position, with a family history of DDH, or who required harness/bracing treatment may have a higher risk of complications like redislocation. A Real-Life Example Imagine a baby, Aditi, who was treated for DDH early with a Pavlik harness. Her hip initially stabilized, but after switching to a spica cast post-reduction, her parents noticed a faint “clunk” during diaper changes. On follow-up, her orthopaedic surgeon found mild instability — the hip had partially subluxated again. Because of regular monitoring and the parent’s attentiveness, Aditi’s treatment was adjusted promptly, and with physiotherapy, she regained a stable and healthy hip. When to Seek Specialist Help If you or your child spot any symptoms of redislocation — especially after a period of treatment — it’s crucial to reconnect with an experienced paediatric orthopaedic specialist. For expert guidance and treatment options tailored to your situation, you may wish to consult a trusted centre like Dr Assad Qureshi’s practice, where evidence-based approaches and close follow-up help manage DDH effectively. Final Thoughts Redislocation in DDH isn’t common, but it’s a serious concern. The good news is that with vigilant care, informed parents, and timely orthopaedic follow-up, many children go on to develop stable, healthy hips. If you suspect your child’s hip is unstable, or if you’d like to learn more about long-term management of DDH, reach out to specialists. Visit Dr Assad Qureshi’s clinic to get expert advice, second opinions, and individualised care plans.