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 joints.
- In mild cases, the
ligaments 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
normal hip anatomy in a child and a
dislocated hip .
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
family history 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
- Extra folds of skin on the inside of the
- 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
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
If the results of a physical exam are unclear, an
imaging test such as an
X-rays may be used to evaluate your child's hip
How is it treated?
Doctors treat DDH by moving
your baby's upper thighbone into the hip socket and keeping it in place while
the hip joint grows. A splint, called a
Pavlik harness , is most often used to keep the joint in place in babies younger
than 6 months. A hard cast, known as a
spica cast , 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. Most children born with looseness (laxity) of the hips will not have
problems. But 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
Frequently Asked Questions