Developmental dysplasia of the hip (DDH) means the hip socket is shallow and the head of the thighbone can slip partly or fully out of it [1]. When it is found early results are good; the first treatment for babies up to 6 months is a Pavlik harness [1]. Untreated, it can lead to leg length difference, an abnormal gait and later hip pain or arthritis [1].
What is DDH?
A condition present from birth in which the hip socket is shallow and the head of the thighbone may slip in and out, or out completely [1].
Who is more likely to have it?
It is more common in first-born babies (less room in the womb), breech births, babies with a family history of DDH and girls; other orthopaedic problems such as clubfoot are also a risk [1].
How is it recognised?
Newborns are screened before leaving hospital. Diagnosis relies on examination and history; imaging depends on age, with ultrasound for younger babies and X-rays showing the bones in older children [1].
Treatment
For babies up to 6 months the first treatment is a Pavlik harness, which holds the hip in place while allowing limited leg movement [1].
If the harness is not enough a spica cast is applied. If other methods fail, or the diagnosis is made after 6 months, surgery is needed, followed by a cast for up to six months [1].
What if it is not treated?
Early detection and treatment give good results. Untreated DDH can cause leg length difference, an abnormal gait, and hip pain or arthritis later in life [1].
When should you ask for an examination?
If one of your baby's legs looks shorter, the skin folds around the hips differ between the two sides, or the legs do not spread as widely on one side; and if there are risk factors such as a first birth, breech position or a family history of DDH [1].
Frequently asked questions
- Is DDH picked up at birth?
- Newborns are screened before leaving hospital; if there are risk factors or any doubt, a repeat examination is needed [1].
- What is a Pavlik harness?
- The first treatment for babies up to 6 months; it holds the hip in place while allowing limited leg movement [1].
- When is surgery needed?
- If the harness is not enough, or the diagnosis is made after 6 months [1].
- Is there a problem if it is not treated?
- Leg length difference, an abnormal gait and later hip pain or arthritis can result [1].
If you have any doubt about your baby's hips, ask for a paediatric orthopaedic examination without waiting.
Sources
- Developmental Dysplasia of the Hip in Children. University Hospitals (UH Rainbow), n.d.. uhhospitals.org
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.