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Embryology of the Hip

- Discussion: (see limb development);
            - at 4 to 6 gestational weeks, the hip joint develops from the cartilaginous anlage;
            - by 7 weeks a cleft develops between precartilagenous cells which are programmed to form the femoral head and acetabulum;
            - by 11 weeks, the hip joint formation is largely complete;
                    - femoral head is completely encircled by the acetabular cartilage;
            - at late gestation, femoral head grows more rapidly than the acetabular cartilage,
                    so that at birth the femoral head is less than 50% covered;
            - at birth, acetabulum is at its most shallow and most lax inorder to maximize hip ROM which facilitates the delivery process;
                    - hip is uncontained in extension and adduction reflecting hip shallowness;
            - after several weeks, acetabular cartilage develops faster than the femoral head, which allows progressively more coverage;
            - normal occurance of hip shallowness and capsular laxity in the neonatal period are inital factors factors involved in DDH