Developmental Dysplasia of the Hip in the Newborn

What is Developmental Dysplasia of the Hip (DDH)?

Developmental Dysplasia of the Hip (DDH) is a problem with the shape of the hip joint. The hip joint is like a ball and socket. In a dislocated hip, the ball comes out of the socket. When the ball is loose within the socket, this is called subluxation of the hip. The condition is found in babies or young children. One or both hips may be involved. It occurs in about 1 out of 1,000 births. Factors which put your child at risk may include any of the following:

• Left hip is more often involved (possibly due to fetal positioning)

• Females: 80% of cases

• Breech birth (may account for 25-45% of DDH cases)

• First born

• Torticollis (stiff neck)

Your child may have some, all or none of these factors. Most children are checked by their pediatricians at birth and in regular follow-up appointments with your doctor. If your pediatrician notices any hip click or instability within the hip joint, they will usually refer your child to a pediatric orthopedic clinic for evaluation.

How is DDH Diagnosed?

Your pediatrician and orthopod will begin with a thorough history and examination of your child’s hips. There is specific historical information the doctor will be looking for including the above mentioned risk factors. On examination of the child, the doctor will perform 2 maneuvers which are painless to the child, but which will help them access the level of instability in the hip. Your doctor may also order an ultrasound or x-ray of the hips to help determine the shape of the ball and socket hip joint and see if the hip is dislocated or subluxed.

How is DDH Treated?

• Treatment of your child’s hips will depend on the exam findings, risk factors and the information gathered from the ultrasound and x-rays.

• Your child may simply need to be followed over time and have follow-up appointments for continued monitoring of the hips. In more extreme cases, a child may be treated in a hip brace or a cloth harness called a Pavlik harness.

• Treatment with a harness or brace can last anywhere from 6-12 weeks depending on the amount of hip instability. Use of the harness or brace will not injure nor hurt your child. It will not delay their normal development including crawling or walking.

• Treating a child early on will help the child to develop normal hips and should prevent any long-term effects of the hip dysplasia.

• A child with a dislocated hip which is not treated may require casting or surgery to place the hip back into joint.

• Your doctor will help you to understand what needs your child may have and which treatment option is most appropriate for your child.