Newborn Medical Series: Developmental Dysplasia of the Hip
Developmental dysplasia of the hip is a condition that causes hip joint problems, mostly in babies and children. The hip joint is a “ball and socket” joint. It’s called that because the top of the thigh bone is ball shaped and fits into part of the pelvic bone (socket).
In development dysplasia of the hip (DDH), the “socket” part of the joint doesn’t form normally. Because of this, the hip joint is too loose and the baby’s femur doesn’t fit into the socket properly. The “ball” part can slip out of the joint. If it slips completely out of the joint, doctors call it “dislocation”.
DDH usually causes no symptoms in babies. Parents normally find out their baby has it during a routine exam. Babies are checked for DDH after birth. Plus, doctors and nurses check for this condition at routine check-ups until a child is walking.
Sometimes, people find out their child has DDH when their child has an x-ray of the hip done for another reason.
In toddlers and older children, DDH can cause symptoms. It can make 1 leg look shorter or turned away from the body. It can also cause a child to limp or walk in an uneven way.
The doctor or nurse will check for this condition by moving your baby’s legs around in the hip joint. He or she will also check to make sure that both legs look the same, and that 1 leg does not seem shorter than the other.
The doctor or nurse might also order an x-ray or imaging test. The test done most often to check for DDH is an imaging test called an ultrasound. The ultrasound or x-ray will be able to determine the positioning of the baby’s hip joint and tell if the socket is too shallow.
Treatment depends mostly on your child’s age.
Babies younger than 2 weeks old aren’t treated right away. That’s because a loose hip joint can be normal in newborn babies. It sometimes gets better on its own. If your baby has a loose hip, the doctors or nurse will keep checking it to see if the condition goes away or lasts.
Treatment for babies ages 2 weeks to 6 months usually involves wearing a device to hold the hip joint in place so that the bones can grow normally. The device most often used is called a “Pavlik harness”. Babies usually need to wear this for 2-3 months.
Treatment for babies and children older than 6 months usually involves a procedure or surgery to put the hip joint bones back in the correct position. Then your child will need to wear a cast for 3 to 4 months to keep the hip joint in place. This cast is called a spica cast.
DDH causing long term problems depends on different factors, including how old your child was when the condition developed and how severe it was. Many babies with this condition have no long-term hip problems. Some children, especially those who developed the condition later in childhood, have hip joint pain or damage later on.
This is a wonderful YouTube video explaining more about Developmental Dysplasia of the Hip.
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Jeri Ford, RN, BSN, CPN
Children’s Hospital of Los Angeles
Up To Date, Inc.