Understanding Developmental Dysplasia of the Hip

Developmental Dysplasia of the Hip (DDH) is a condition in which the hip joint is
not properly formed in newborn babies and infants. Found in every 1 in 1,000
babies, DDH is a treatable condition, detected and diagnosed through a physical

Hip Physiology

The hip joint is a “ball-in-socket” joint, meaning that the rounded top of the femur
naturally fits into the cup-shaped hip socket. This spheroidal structure provides
the freest range of motion of any type of joint, and is also found in the shoulder.
Thanks to the “ball-in-socket,” we can swing, twist, and bend our arms and legs
with ease.

In DDH, the hip socket is underdeveloped, meaning that it is too shallow to
properly hold the femoral head. This means that the hip joint is “loose,”
sometimes to a point of dislocation. In turn, the surrounding ligaments may
stretch or loosen, which can cause pain, reduce mobility, and hinder growth.
Severity of DDH ranges from subluxatable (loose in the socket) to complete
dislocation (entirely out of the socket).

Diagnosing DDH

In the first few days after birth, every baby undergoes a physical exam. Part of this
exam includes checking for DDH by gently moving the baby’s hips. If the baby
experiences any pain with this motion, it is likely they have DDH to some degree.

If the infant shows symptoms of DDH, the next step is to conduct an ultrasound
scan. An ultrasound is also recommended if they have a family history of hip
issues, was born or spent time in breech position, is a twin, or is high-risk in any
way. DDH is also more common in first-born babies and in females.

Some cases of DDH take longer to develop or are virtually unidentifiable. Some
covert symptoms to look out for are different sized legs, one leg “dragging” when
they crawl, uneven skin folds, an abnormal walk, or restricted
movement/flexibility in one leg. If your baby shows any of these symptoms,
contact your doctor as soon as possible.

Treating Developmental Dysplasia of the Hip

When doctors identtify DDH during infancy, they can usually treat the baby with a
Pavlik harness, a soft fabric splint that secures and stabilizes the hips. Per your
doctor’s instruction, the harness is easily adjustable and removable with time.

If DDH is severe, if the Pavlik harness is ineffective, or if the child is diagnosed
with DDH after 6 months of age, they may require orthopedic surgery. This
surgery poses minimal risk and is very effective. Based on the individual’s age and
level of severity, surgical options may include closed reduction or open hip
surgery. Recovery usually requires wearing a cast for several months.

It’s important to remember that DDH is typically congenital, meaning that it’s
unpreventable. The only instance that it can be directly caused is through
prolonged, unsafe swaddling techniques. Always make sure to practice healthy
swaddling, which allows your infant to move their hips and legs freely.

For more information about hip and other orthopedic conditions, contact a board-certified orthopedic physician. Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC
is double board certified in orthopedic surgery and sports medicine. Dr. Grossfeld
serves patients of all ages from children to adults throughout Kentucky and
Southern Indiana. For additional information or to schedule an appointment call
Dr. Grossfeld’s office at 502-212-2663.