DDH & SCFE Treatment

What is DDH & SCFE?

Developmental dysplasia of the hip, also known as DDH, is a problem with the way the hip joint of the baby forms. The condition may begin even before the baby is born. In some cases, it may happen after birth, during the growth years of the baby. DDH may affect one or both hips.

Slipped capital femoral epiphysis, also known as SCFE, refers to a hip disorder that affects adolescents during their growth years. The condition is characterised by a rounded top of the thigh bone slipping backward and downward from the normal position at the growth plate. SCFE occurs between the ages of 10 and 16 when rapid growth and hormonal changes put too much stress on the growth plate.

Causes

Causes of DDH

• DDH may be caused by a family history of hip dislocation. If the parent of the newborn has experienced hip dysplasia during their childhood, it increases the risk of the baby developing this condition by 12%.
• The condition may be the result of moulding abnormalities in the uterus, which is too small.
• According to doctors, a breech birth may also be the cause of DDH in babies. Breech birth is when the baby emerges from the birth canal buttocks-first instead of head-first.

Causes of SCFE

• SCFE may be caused by hormonal changes during puberty that soften the growth plate.
• It may be the result of increased mechanical stress from body weight and physical activity.
• The condition develops due to rapid bone growth that temporarily weakens the growth plate.
• SCFE may also be caused by any underlying condition, including thyroid disorders or kidney disease.

Symptoms

Symptoms of DDH

• A limb length discrepancy where one leg looks shorter than the other on the affected side.
• Limp in the leg.
• A waddling gait.
• Restricted range of motion of the hip joint.
• Unilateral tip-toe walking on one foot.

Symptoms of SCFE

• Occasional episodes of pain in the hip, groin, knee, or thighs for several weeks.
• Pain that worsens with daily activities of life.
• Running or walking with a limp after a period of activity.
• Out-toed gait.
• Inability to put weight on the affected leg.
• Outward turning or external rotation of the affected leg.
• Discrepancy in leg length.

How are DDH & SCFE Diagnosed?

Both DDH and SCFE should be diagnosed at the right time so that treatment may reverse the condition and stop it from recurring. A paediatric orthopaedic specialist uses the following ways to diagnose these conditions.

Diagnosis of DDH

As the baby turns six months old, the doctor carries out a physical examination by using specific manoeuvres to check the hip joint. If it makes any clicking or clunking sound, it may indicate a dislocation.

• The doctor tries to reduce the dislocated hip joint by pushing the hip inside and moving the thigh to the outside. This test is called the Ortolani manoeuvre test.
• The doctor tries to dislocate the hip by taking the thigh inward and pushing the hip posteriorly. This test is called the Barlow test.
• They may also order scanning tests, such as an X-ray of the pelvis, an MRI, or a CT scan, to confirm the diagnosis.

Diagnosis of SCFE

The doctor will carry out a physical examination of the child. During this examination, they will ask about their general health, medical history, and the duration of their symptoms. They will ask the child to lie down and perform a careful examination of the affected leg and hip to look for the following:

• Pain with extremes of motion.
• Limited range of motion in the hip, especially limited internal rotation.
• Involuntary muscle guarding and muscle spasms.

How are DDH & SCFE Treated?

DDH Treatment in Delhi

Depending on the severity of the condition, the age of the child, and other essential factors, the paediatric orthopaedic specialist may choose one of the following approaches to treat DDH in babies:

• Bracing.
• A closed reduction and casting.
• An open reduction surgery and casting.

Surgery is usually the last option of treatment. A brace or cast helps to hold the hip in place. The doctor puts them on both sides even if only one hip is affected.

SCFE Treatment in Delhi

The treatment of SCFE aims at preventing further slipping and preserving hip function. The initial line of treatment includes resting, casting, or physical therapy to allow movement and reduce pain. When all the conservative treatment options do not provide relief, the surgeon uses one of the following surgical options to treat the condition:

• In Situ Fixation: A single screw is placed across the growth plate to stabilise the femoral head in its current position.
• Emergency Surgery: Required for unstable slips to minimise complications.
• Prophylactic Fixation: May be recommended for the unaffected hip if the risk of developing the condition is too high.

Cost of DDH & SCFE Treatment in Delhi

The cost of DDH and SCFE treatment in Delhi varies significantly, characterised by the severity of the condition and the type of procedure used by the doctor. An average treatment cost starts from ₹1,40,000 and may range up to ₹5,00,000. The following factors affect the overall cost of the treatment:

• Costs in private hospitals are higher than in government medical facilities.
• An experienced surgeon or a paediatric orthopaedic specialist charges higher for the procedure.
• The duration of stay in the hospital is also taken into consideration to determine the overall costs.

Recovery After Treatment

Babies with DDH are expected to wear a brace or cast for several months to recover completely from the condition. If DDH is not treated, the child may develop a painless limp, and over time, it may develop into arthritis. Do not remove the braces until the doctor suggests, and keep visiting them for a follow-up.

In the case of SCFE, the post-surgical rehabilitation focuses on safe recovery and gradual return to activities. During the initial phase of recovery, the patient will be asked to use crutches or a walker. The doctor will prescribe pain management medication to manage pain and swelling. For swelling, an ice application also works well. The patient will be put on physical therapy for the gradual restoration of hip movement, strength, and walking pattern. Until complete recovery, high-impact sports activity should be strictly avoided.

Why Choose Dr. Ashwani Maichand for DDH & SCFE Treatment?

Choosing Dr. Ashwani Maichand for DDH and SCFE treatment ensures expert care and proper rehabilitation. With three decades of experience in complex hip preservation and reconstruction procedures, Dr. Maichand has delivered successful outcomes in treating simple and complex cases related to DDH and SCFE.

Dr. Maichand focuses on preserving the natural hip joint, helping patients regain mobility, reduce pain, and prevent future complications, including early arthritis. His patient-centred approach, careful treatment planning, and commitment to minimally invasive practices ensure safe procedures in children and allow for faster recovery and better long-term outcomes for both children and adolescents.

FAQs

Suspect DDH or SCFE in your child or teen? Contact Dr. Ashwani Maichand early — timely care preserves the hip for life.