Developmental Dysplasia of the HipTopic Overview
What is developmental dysplasia of the hip (DDH)?
Developmental dysplasia of the hip (DDH) is the name for a range of conditions
of the hip. In mild cases, the ligaments and other soft tissues around the hip
joint are not tight, and they allow the thighbone (femur) to move around more
than normal in the hip socket. In more severe cases, the joint is loose enough
to let the thighbone come partway out of the hip socket. This is called
subluxation. Actual "dysplasia" is the most severe form of the condition. If a
child has hip dysplasia, the socket is too shallow, more like a saucer than the
deep cup that it should be. This allows the ball at the top of the thighbone
(femoral head) to either partly or fully slip out of the socket (dislocate).
DDH can affect one or both hip joints. See pictures of
normal hip anatomy in a child  and a
dislocated hip . What causes DDH? The exact cause of DDH is not
known. But a number of risk factors can raise your child's chances of having
DDH, including a family history of DDH and your baby's position in the womb and
at birth. What are the symptoms? A baby with DDH may
have: - A hip joint that feels loose or slips out of
place when examined.
- One leg that appears to be shorter than the
other.
- Extra folds of skin on the inside of the
thigh(s).
- A hip joint that moves differently than the other.
A child who is walking may: - Walk on the toes of one foot with the heel up
off the floor. The child walks this way because one leg is shorter than the
other.
- Walk with a limp (or waddling gait if both hips are
affected).
How is DDH diagnosed? Usually, DDH is diagnosed
during your newborn's physical examination. If your baby is older, DDH may be
diagnosed during a well-baby checkup. But it may be more difficult to diagnose
the condition in a baby older than 1 to 3 months, because the only outward sign
may be less mobility or flexibility in the movement of the affected hip
joint(s). If the results of a physical examination are unclear, an
imaging test such as an
ultrasound or
X-rays may be used to evaluate your child's hip
joints. How is it treated? DDH is treated by moving your
baby's upper thighbone into the hip socket and keeping it in place while the
joint grows. A harness, called a
Pavlik harness , is most often used to keep the joint in place in babies younger
than 6 months. A hard cast, known as a
spica cast , is used for older babies. Other forms of treatment, such as
surgery or a brace, also may be needed. Most children born with
looseness (laxity) of the hips will not have problems. But a child will not
outgrow severe DDH in which the hip sockets are too shallow. The condition
requires treatment from a doctor to prevent possible permanent disability. You
should not try to treat DDH on your own, such as by diapering a baby with 3 or
4 diapers at a time or by trying to put your baby's legs in certain positions.
These are not effective treatments for DDH and may cause the joint to develop
abnormally. Frequently Asked Questions Learning about developmental dysplasia of the hip (DDH): | | Being diagnosed: | | Getting treatment: | | Living with DDH: | |
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