Skip to Content

Menu Icon
Menu
Menu Icon

Developmental Dysplasia of the Hip

Topic Overview

What is developmental dysplasia of the hip (DDH)?

Developmental dysplasia of the hip (DDH) is a hip problem a baby is born with or that happens in the first year of life. In this condition, the top of the thighbone doesn't fit securely into the hip socket. This problem may affect one or both hip joints.

In a normal hip, the thighbone fits tightly into a cup-shaped socket in the pelvis, and it is held in place by muscles, tendons, and ligaments. But in DDH, the hip socket may be too shallow or the tissues around the joint may be too loose.

  • In mild cases, the ligaments and other soft tissues aren't tight, so the thighbone (femur) moves around more than normal in the hip socket.
  • In more severe cases, the hip socket is more like a saucer than the deep cup that it should be. As a result:
    • The ball at the top of the thighbone (femoral head) may slip partway out of the hip socket. This is called subluxation.
    • The femoral head may slide completely out of the hip socket. This is called dislocation.

It's important to get DDH treated early. The longer it goes on, the more likely it is to cause long-term hip problems.

What causes DDH?

The exact cause of DDH is not known. But some things can raise your child's chances of having it, including:

  • Having a family history of DDH.
  • Being the firstborn child.
  • Being female.
  • Being born buttocks-first (breech position).

What are the symptoms?

DDH isn't painful, and your baby may not have any obvious signs of a hip defect. But some babies with this problem may have:

  • One leg that seems shorter than the other.
  • Extra folds of skin on the inside of the thighs.
  • 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 waddle if both hips are affected).

How is DDH diagnosed?

It is usually diagnosed during a newborn's physical exam. A doctor will move the baby's legs and look and listen for signs of a problem.

If your baby is older, your doctor may diagnose DDH during the physical exam at a well-baby checkup. But it may be hard to diagnose in a baby more than 1 to 3 months old. That's because the only outward sign may be a hip joint that is less mobile or flexible than normal.

If the doctor suspects DDH but the results of a physical exam aren't clear, your child might need to have an imaging test of the hip joint, such as an ultrasound or X-ray.

How is it treated?

Your child's hip socket won't form and grow properly if the ball at the top of the thighbone doesn't fit snugly in the joint. So treatment focuses on moving the thighbone into its normal position and keeping it in place while the joint grows.

Your child may need:

  • A Pavlik harness. This device will probably be tried first if your baby is younger than 6 months. It holds your baby's legs in a spread position with the hips bent. The harness is able to make the hips normal most of the time.
  • A hard cast, known as a spica cast. This is used for older babies. The cast keeps the hips in the proper position. It may have a bar between the legs to make it stronger.

Other forms of treatment that may be needed include:

  • Braces or splints. These may be used instead of a Pavlik harness or spica cast. Or they may be used after surgery.
  • Surgery. In some cases, this may be needed to correct a deformed thighbone or hip socket. A child who has surgery will probably need to wear a spica cast to position the hip joint until it heals.
  • Physical therapy. A child who has been in a spica cast may need to do exercises to regain movement and build muscle strength in the legs.

If treatment is successful, your child probably won't have any further hip problems. But get your child's hips checked regularly to make sure they continue to grow and develop normally.

Health Tools Health Tools help you make wise health decisions or take action to improve your health.

Health Tools help you make wise health decisions or take action to improve your health.


Actionsets help people take an active role in managing a health condition. Actionsets are designed to help people take an active role in managing a health condition.
  Hip Dysplasia: Caring for Your Child in a Body (Spica) Cast

Other Places To Get Help

Organization

HealthyChildren.org
141 Northwest Point Boulevard
Elk Grove Village, IL 60007
Phone: (847) 434-4000
Web Address: www.healthychildren.org
 

This American Academy of Pediatrics website has information for parents about childhood issues, from before the child is born to young adulthood. You'll find information on child growth and development, immunizations, safety, health issues, behavior, and much more.


References

Other Works Consulted

  • American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Developmental dysplasia of the hip. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 1050–1055. Rosemont, IL: American Academy of Orthopaedic Surgeons.
  • Delahay JN, Lauerman WC (2010). Children’s orthopedics. In SM Wiesel, JN Delahay, eds., Essentials of Orthopedic Surgery, 4th ed., pp. 173–251. New York: Springer.
  • Erickson MA (2012). Orthopedics. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 830–848. New York: McGraw-Hill.
  • Podeszwa DA (2011). Developmental dysplasia of the hip. In CD Rudolph et al., eds., Rudolph’s Pediatrics, 22nd ed., pp. 852–856. New York: McGraw-Hill.
  • Sankar WN, et al. (2011). The hip. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 2355–2365. Philadelphia: Saunders.
  • Shah SA, Stankovits LM (2006). The hip. In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 1016–1021. Philadelphia: Saunders.
  • U.S. Preventive Services Task Force (2006). Screening for developmental dysplasia of the hip. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspshipd.htm.
  • White KK, Goldberg MJ (2012). Common neonatal orthopedic ailments. In CA Gleason, SU Devaskar, eds., Avery's Diseases of the Newborn, 9th ed., pp. 1351–1361. Philadelphia: Elsevier Saunders.

Credits

By Healthwise Staff
John Pope, MD - Pediatrics
Susan C. Kim, MD - Pediatrics
Last Revised November 12, 2013

Last Revised: November 12, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Decision Points

Our interactive Decision Points guide you through making key health decisions by combining medical information with your personal information.

You'll find Decision Points to help you answer questions about:

Interactive Tools

Get started learning more about your health!

Our Interactive Tools can help you make smart decisions for a healthier life. You'll find personal calculators and tools for health and fitness, lifestyle checkups, and pregnancy.

Symptom Checker

Feeling under the weather?

Use our interactive symptom checker to evaluate your symptoms and determine appropriate action or treatment.