Developmental Dysplasia of the Hip

The hip joint is a “ball and socket” made up of the upper end of the thigh bone and the acetabulum (cup) of the pelvis.  Developmental dysplasia of the hip (DDH) occurs when the ball is not stable in the socket in young children or babies. This condition is present at birth and is characterized by loose ligaments and connective tissue around the hip or a shallow socket, causing laxity in the joint and may result in the bone completely or partially out of the hip socket. There is a higher risk for DDH in females, first born children, family history of DDH, and breech position in pregnancy (baby’s bottom is down).

Pediatricians will screen newborns for this condition and at subsequent check-ups. There may be no symptoms present.  Some babies born with a dislocated hip will show uneven skin folds in the thigh, difference in leg length, less movement in the affected leg, and abnormal gait.

Your doctor will manipulate the leg and hip, often reproducing a click or “clunk.” Ultrasound can be used to confirm the diagnosis in newborns and infants.  Sometimes, x-rays are ordered to assess the hip joint in older infants and children.

Treatment for DDH depends on the age of the child. In newborns, a Pavlik harness is used for up to 12 weeks, allowing the hip to stay in the socket while the surrounding ligaments tighten up. Children diagnosed after 6 months of age usually require surgery to put the hip in place and placement of a body cast to allow proper healing. Treatment for DDH is necessary to reduce risk of early arthritis and hip deterioration.