Kim Muoy R., 1

At the age of 2 years, Kim Muoy, an only child, resides with her parents and grandfather a three-hour tuk-tuk journey away from Phnom Penh. Her parents, dedicated rice farmers, do their best to provide for their family. Kim Muoy's family has faced challenges, with her father losing four fingers in a farming accident, causing her mother to shoulder much of the farming responsibilities. She is too young to attend school, and enjoys the company of her grandfather, and engaging in imaginative play with her cherished dolls. Her simple pleasures at home include her favorite meal – fried eggs.

im Muoy presented challenges during examination due to her distress. While she could walk independently, her gait was abnormal, and she experienced limitations in hip abduction. Doctors diagnosed her with developmental dysplasia of the hip, indicating a dislocated or predisposed-to-dislocate hip joint. Additionally, Kim Muoy was small and underweight for her age. Following hip surgery, Kim Muoy's condition has improved, although she still needs to gain weight. She has been provided with nutritional supplements to aid in weight gain. Currently, she wears a spica cast to immobilize her hip during the recovery period. It's crucial to promptly change her diapers to prevent soiling or wetting of the plaster, minimizing the risk of skin irritation. Once the cast is removed, Kim Muoy will undergo physiotherapy exercises to restore hip function and improve mobility. Often, a brace may be utilized post-cast removal to support the hip joint for additional weeks, particularly during nighttime. Maintaining stability in her hip joint is vital to prevent re-dislocation even after the cast is removed. With complete recovery, she is expected to experience improved walking abilities.

In early November Kim Muoy had a closed reduction of her hips under anesthesia and a spica cast placed. When she returned last week, her hips had dislocated again, so she is scheduled for an open reduction of her right hip and pelvic osteotomy. Around 95 percent of babies born with DDH can be successfully treated with surgery aimed at correcting the curvature of Kim Muoy's spine and stabilize her hip joints, allowing for normal growth and development. Early detection and intervention are crucial in managing DDH. Treatment options vary based on the severity of the condition and the child's age. In this case, she requires surgical intervention such as closed or open reduction, and osteotomy.