Frequency of Risk factors for Developmental Dyslasia of Hip (DDH) in patients presenting to a Tertiary Care Hospital.


  • Junaid Zeb Consultant Trauma and Orthopaedics, Russell Hall Hospital, The Dudley Group NHS Foundation Trust UK
  • Sikandar Hayat Associate Professor Department of Orthopaedics Khyber Teaching Hospital, Peshawar.
  • Imran Afzal Orthopaedics and Spine Unit, Hayatabad Medical Complex, Peshawar.
  • Sheikh Naeem U Haq Assistant Professor Dow University of Health Sciences Karachi
  • Muhammad Shoaib Orthopaedics and Spine Unit, Hayatabad Medical Complex, Peshawar.
  • Marwa Zeb Bannu Medical College Bannu
  • Shehla Khatoon Khyber Medical College, Peshawar


Objective: To determine the frequency of risk factors for developmental dysplasia of hip (DDH) in patients presenting to a tertiary care hospital.

Methods: This cross-sectional study was conducted in Department of Orthopedics and Trauma of Khyber Teaching Hospital (KTH), Peshawar from 26th October 2020 to 26th April 2021. Parents of all children with DDH fulfilling the inclusion criteria were interviewed for identifying risk factors for DDH. Data stratification was done for comparison of important variables. Statistical significance was determined by calculating P value with Chi square test and Fischer exact test. P values < 0.05 was considered significant.

Results: In this study 163 children with DDH were included. The mean age was 7.56±3.357 years. Males were 91(55.8%) and female were 72(44.2%). History of oligohydramnios was noted in 43 (26.385) children and breach presentation in 34(20.9%). Pre term children were 23 (14.11) and post term 22 (13.50). Family history was positive in 17 (10.43) children. The frequency of DDH was more in female children with full term and in male children with post term and positive family history (P<0.05)

Conclusion: Oligohydramnios, breach presentation and preterm delivery were the most frequently noted risk factors present in more than half of our patients of DDH in our series.


de Hundt M, Vlemmix F, Bais JM, Hutton EK, de Groot CJ, Mol BW, Kok M. Risk factors for developmental dysplasia of the hip: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2012;165(1):8-17.

Forlin E, Munhoz da Cunha LA, Figueiredo DC. Treatment of developmental dysplasia of the hip after walking age with open reduction, femoral shortening, and acetabular osteotomy. Orthop Clin North Am. 2006 ;37(2):149-160.

Colta RC, Stoicanescu C, Nicolae M, Oros S, Burnei G. Hip dysplasia screening - epidemiological data from Valcea County. J Med Life. 2016;9(1):106-111.

Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011;2011:238607. doi: 10.5402/2011/238607.

Çekiç B, Erdem-Toslak ?, Sertkaya Ö, Filiz S, K?lar Y, Köro?lu M, Köse Ö. Incidence and follow-up outcomes of developmental hip dysplasia of newborns in the Western Mediterranean Region. Turk J Pediatr. 2015 ;57(4):353-458.

Kolb A, Chiari C, Schreiner M, Heisinger S, Willegger M, Rettl G, Windhager R. Development of an electronic navigation system for elimination of examiner-dependent factors in the ultrasound screening for developmental dysplasia of the hip in newborns. Sci Rep. 2020 ;10(1):16407. doi: 10.1038/s41598-020-73536-9.

Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? World J Orthop. 2015 ;6(11):886-901.

Lehmann HP, Hinton R, Morello P, Santoli J. Developmental dysplasia of the hip practice guideline: technical report. Committee on Quality Improvement, and Subcommittee on Developmental Dysplasia of the Hip. Pediatrics. 2000 ;105(4):E57. doi: 10.1542/peds.105.4.e57.

Lambeek AF, De Hundt M, Vlemmix F, Akerboom BM, Bais JM, Papatsonis DN, Mol BW, Kok M. Risk of developmental dysplasia of the hip in breech presentation: the effect of successful external cephalic version. BJOG. 2013 ;120(5):607-12. doi: 10.1111/1471-0528.12013.

Janssen D, Kalchschmidt K, Katthagen BD. Triple pelvic osteotomy as treatment for osteoarthritis secondary to developmental dysplasia of the hip. Int Orthop. 2009 Dec;33(6):1555-1559.

El-Sayed M, Ahmed T, Fathy S, Zyton H. The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: short- to middle-term follow-up. J Child Orthop. 2012;6(6):471-477.

McKibbin B. Anatomical factors in the stability of the hip joint in the newborn. J Bone Joint Surg Br. 1970 ;52(1):148-159.

Ralis Z, McKibbin B. Changes in shape of the human hip joint during its development and their relation to its stability. J Bone Joint Surg Br. 1973;55(4):780-785.

Ziegler J, Thielemann F, Mayer-Athenstaedt C, Günther KP. Natürlicher Verlauf von Hüftreifungsstörungen und Hüftdysplasie. Eine Metaanalyse publizierter Literatur [The natural history of developmental dysplasia of the hip. A meta-analysis of the published literature]. Orthopade. 2008;37(6):515-6, 518-24. German. doi: 10.1007/s00132-008-1238-0.

Getz B The hip joint in Lapps and its bearing on the problem of congenital dislocation. Acta Orthop Scand Suppl. 1955;18:1-81.

Hoaglund FT, Yau AC, Wong WL. Osteoarthritis of the hip and other joints in southern Chinese in Hong Kong. J Bone Joint Surg Am. 1973;55(3):545-557.

Sankar WN, Weiss J, Skaggs DL. Orthopaedic conditions in the newborn. J Am Acad Orthop Surg. 2009 Feb;17(2):112-22.

Salman M, Hayat S, Saqib M, Gulzada. Short term results of Antero lateral approach for open reduction of neglected Developmental dysplasia of Hip (DDH). J Pak Orthop Assoc.2019; 31(10:15-19.

Karmazyn BK, Gunderman RB, Coley BD, Blatt ER, Bulas D, Fordham L, et al. American College of Radiology. ACR Appropriateness Criteria on developmental dysplasia of the hip--child. J Am Coll Radiol. 2009 Aug;6(8):551-557.

AIUM-ACR-SPR-SRU Practice Parameter for the Performance of an Ultrasound Examination for Detection and Assessment of Developmental Dysplasia of the Hip. J Ultrasound Med. 2018;37(11):E1-E5. doi: 10.1002/jum.14829.




How to Cite

Junaid Zeb, Sikandar Hayat, Imran Afzal, Sheikh Naeem U Haq, Muhammad Shoaib, Marwa Zeb, & Shehla Khatoon. (2023). Frequency of Risk factors for Developmental Dyslasia of Hip (DDH) in patients presenting to a Tertiary Care Hospital. Journal of Pakistan Orthopaedic Association, 34(04), 163–165. Retrieved from