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Developmental Dysplasia of the Hip

Developmental dysplasia (dislocation) of the hip (DDH) occurs when a child’s hip joint has not formed properly. The seriousness of the condition can range from the hip being slightly displaced to being dislocated easily. Approximately 1 in 1,000 children are born with a dislocated hip and 10 in 1,000 may have hip subluxation (partial dislocation).

Causes

DDH often runs in families. Other factors that can influence whether a child has DDH are:

  • Breech birth
  • Being female
  • Being the first born
  • Oligohydramnios (when there is not enough amniotic fluid surrounding the fetus during pregnancy)

Diagnosis

Early diagnosis helps improve treatment results, so a careful physical examination is recommended as a screening tool. Children older than 6 weeks may be given an ultrasound or other types of medical imaging.

Children with DDH may have:

  • Hip instability
  • Unequal leg lengths
  • Uneven thigh skinfolds
  • Limping, toe-walking or other gait abnormalities
  • Less flexibility on one side

Treatment

In newborns and infants up to 6 months of age, a Pavlik harness is the treatment of choice. The harness positions the hips while allowing motion. If a dislocated hip is not reduced the harness should be discontinued and alternative treatment selected. In children older than 6 months, closed reduction under general anesthesia and hip spica casting is the treatment of choice.

Surgery is more difficult in older children with established dislocations. The goal of a surgical procedure is to normalize the hip joint to delay or prevent premature onset of osteoarthritis.

Learn about our care in the Division of Orthopaedic Surgery.

Related Specialties & Services

Read about the specialty areas and services that treat Developmental Dysplasia of the Hip.