Developmental dysplasia of the hip (DDH) is commonly referred to as “hip dysplasia” and is a condition in which the relationship between the hip socket and femoral head is abnormal. It may be present at birth or occur in an infant or child's development. The hip joint is created as a ball and socket joint. In DDH, the hip socket may be shallow, letting the "ball" of the long leg bone, also known as the femoral head, slip in and out of the socket. The "ball" may move partially or completely out of the hip socket. The greatest incidence of DDH occurs in first-born females with a history of a close relative with the condition.
Condition
What Is Hip Dysplasia?
Risk Factors and Symptoms of Hip Dysplasia
Some of the common risk factors associated with DDH:
- Female gender
- First born infants thought due to the mother's uterus being smaller and there is therefore less room to move
- Position of the baby in uterus such as breech presentation
- Family history of DDH
- Associations with other orthopedic conditions such as clubfoot deformity, congenital conditions, and other syndromes
While each baby may experience symptoms differently, the most common symptoms of DDH are:
- The leg may appear shorter on the side of the dislocated hip
- The leg on the side of the dislocated hip may turn outward
- The folds in the skin of the thigh or buttocks may appear uneven
The symptoms of DDH may resemble other medical conditions of the hip. Always consult your baby's physician for a diagnosis.
Treatments We Offer
DDH is sometimes noted at birth. The pediatrician or newborn specialist screens newborn babies in the hospital for this hip problem before they go home. However, DDH may not develop until later in infancy or childhood so your pediatrician may diagnose it at a later well child visit. Your baby's physician makes the possible diagnosis of developmental dysplasia of the hip with a clinical examination. They may then order certain diagnostic tests to confirm diagnosis. These tests include:
Specific treatment for DDH will be determined by your baby's physician and orthopedic specialist based on:
- Your baby's age, overall health and medical history
- The extent of the condition
- Expectations for the course of the condition
- Your opinion or preference
The goal of treatment is to maintain the femoral head into the socket of the hip so that the hip can develop normally. Treatment options vary for babies and may include:
- Use of a Pavlik harness: A Pavlik harness is used on babies up to 6 months of age to hold the hip in place, while allowing the legs to move a little. The harness is put on by your baby's physician and is usually worn full time for at least six weeks, then part-time (12 hours per day) for six weeks. Your baby is seen frequently during this time so that the harness may be checked for proper fit and to examine the hip. At the end of this treatment, X-rays (or an ultrasound) are used to check hip placement. The hip may be successfully treated with the Pavlik harness, but sometimes, it may continue to be partially or completely dislocated.
- Casting: If the hip continues to be partially or completely dislocated, often casting or surgery may be required to help relocate the hip. This cast is called a hip spica cast and is applied from the chest to the thighs or knees. This type of cast is used to hold the hip in place after surgery to allow healing.
- Surgery: If surgery is done, a special cast called a spica cast is put on the baby to hold the hip in place. The spica cast is worn for approximately three to six months. The cast is changed from time to time to accommodate the growth.
Why Choose Children’s Wisconsin for Hip Dysplasia Care
Expert pediatric care: At Children’s Wisconsin, our Orthopedics Program specializes in all areas of orthopedic care, from upper extremity, trauma, spine and fracture care to sports medicine and concussion care. We treat all orthopedic conditions, from routine to serious. Kids are not just little adults, and require unique, individualized care for their developing little bodies. Our doctors are pediatric experts and every doctor specializes 100% in kids and teens.
Our Doctors
At Children's Wisconsin, our doctors are 100% committed to the health and well-being of kids. They care for every aspect of a child's health, including their physical, social, dental and mental well-being. We are a community of dedicated professionals who shares an unwavering passion to care for kids whenever and wherever they need us.