An estimated one out of every 1,000 children is born with a dislocated hip, otherwise known as hip dysplasia. With hip dysplasia, also called DDH, the hip socket is more shallow, often letting the ball of the leg bone slip in an out of the socket more than it should. If left untreated, hip dysplasia can lead to deformity, decreased agility, or pain and osteoarthritis in adulthood.

Cause

Hip dysplasia is most common in first-borns who have a close relative with the condition. This is due to the fact that the uterus of a mother is often smaller with her first child, giving the baby less room to move around. In turn, this affects the baby's hip development. 

There are several genetic and environmental factors that can also lead to hip dysplasia, as well as a baby's response to his or her mother's hormones during pregnancy.

Symptoms

With hip dysplasia, the leg on the side with the dislocated socket may be noticeably shorter than the other leg. This leg may also turn outward, or the space between the legs may seem wider. Pediatricians will usually screen newborns to check for these indications at birth. However, in some cases, DDH may not be diagnosed until follow-up appointments occur. 

To confirm a hip dysplasia diagnosis, a healthcare provider may conduct an x-ray or an ultrasound.

Treatment

A variety of treatments can be used to help place the head of the affected leg back into the hip socket, allowing a child to develop normally. One treatment option is the use of a special harness that holds a child’s hip in place while still allowing for movement. This harness, called a Pavlik harness, is usually worn for about two months.

If the hip does not improve, a pediatrician or orthopedic specialist may recommend surgery or a cast. A surgical procedure known as “closed reduction” puts the hip back in place manually, followed by a “spica cast” to hold the hip in place. The cast remains on the hip until the hip returns to normal placement.

Following casting, a special brace and/or physical therapy exercises may be necessary to make the muscles around the hip and in the legs stronger. It is important to keep the cast clean and dry, observe it for cracks or breaks, and to avoid putting anything inside the cast.


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