Developmental Dysplasia of the Hip

What is developmental dysplasia of the hip (DDH)?

Developmental dysplasia of the hip (DDH) is the name for a range of conditions of a child's hip. It can affect one or both hip Reference joints Opens New Window.

• In mild cases, the Reference ligaments Opens New Window 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 ball at the top of the thighbone (femoral head) come partway out of the hip socket. This is called subluxation.
• Dislocation is the most severe form of DDH. The ball at the top of the thighbone fully slips out of the hip socket (dislocates).

With subluxation or dislocation, the hip socket is often too shallow, more like a saucer than the deep cup that it should be.

See pictures of Reference normal hip anatomy in a child Opens New Window Reference Opens New Window and a Reference dislocated hip Opens New Window Reference Opens New Window.

What causes DDH?

The exact cause of DDH is not known. A number of risk factors can raise your child's chances of having DDH, including a Reference family history Opens New Window of DDH and your baby's position in the womb and at birth.

What are the symptoms?

Having DDH does not cause pain. A baby with DDH may have:

• A hip joint that feels loose or slips out of place when examined.
• One leg that seems 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.
• 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 exam. If your baby is older, DDH may be diagnosed during a well-baby checkup. But it may be harder 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 exam are unclear, an imaging test such as an Reference ultrasound Opens New Window or Reference X-rays Opens New Window may be used to evaluate your child's hip joints.

How is it treated?

Most children born with looseness (laxity) of the hips won't have problems and won't need treatment. If treatment is needed, the doctor will move your baby's upper thighbone into the hip socket and keep it in place while the hip joint grows. A splint, called a Reference Pavlik harness Opens New Window Reference Opens New Window, is most often used to keep the joint in place in babies younger than 6 months. A hard cast, known as a Reference spica cast Opens New Window Reference Opens New Window, is used for older babies. Other forms of treatment, such as surgery or a brace, also may be needed.

It's important to treat DDH early. Children with untreated DDH may develop lasting hip problems. Don't 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 methods don't work well and may cause the joint to develop abnormally.

Frequently Asked Questions

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