Health Encyclopedia

Developmental dysplasia of the hip

Definition

Developmental dysplasia of the hip (DDH) is a dislocation of the hip joint that is present at birth. The condition is found in babies or young children.

Alternative Names

Developmental dislocation of the hip joint; Developmental hip dysplasia; DDH; Congenital dysplasia of the hip; Congenital dislocation of the hip; CDH

Causes, incidence, and risk factors

The hip is a ball and socket joint. The ball, called the femoral head, forms the top part of the thigh bone (femur) and the socket (acetabulum) forms in the pelvis.

The hip may be all the way out of the joint or the socket may be a little shallow. One or both hips may be involved.

The cause is unknown, but genetic factors may play a role. Low levels of amniotic fluid in the womb during pregnancy can increase a baby's risk of DDH. Other risk factors include:

Being the first child
Being female
Breech delivery
Family history of the disorder

DDH occurs in about 1 out of 1,000 births.

Symptoms

There may be no symptoms. Symptoms that may occur can include:

Different (asymmetric) leg positions
Reduced movement on the side of the body affected by the dislocation
Shorter leg on the affected side
Uneven folds of thigh fat

After 3 months of age, the affected leg may turn outward or be shorter than the other leg

Signs and tests

Pediatricians routinely screen all newborns and infants for hip dysplasia. There are several methods to detect a dislocated hip or a hip that is able to be dislocated.

Ultrasound of the hip is the most important method to show the hip problem. An x-ray of the hip joint may help diagnose the condition in older infants and children.

A hip that is truly dislocated in an infant should be detected at birth, but some cases are mild and symptoms may not develop until after birth, which is why multiple exams are recommended. Some mild cases are silent and cannot be found during a physical exam.

Treatment

In early infancy, positioning with a device to keep the legs apart and turned outward (frog-leg position) will usually hold the hip joint in place. If there is a problem in maintaining proper position, a cast may be place on the child's leg and changed as the child grows.

Surgery may be necessary if early measures to put the joint back in place are unsuccessful or if the problem is first detected in an older child.

Expectations (prognosis)

If the dysplasia is picked up in the first few months of life, it can almost always be treated successfully with bracing. In a few cases, surgery is necessary to put the hip back in joint. An older age at diagnosis may be associated with a worse outcome and may require more complex surgery to repair the problem.

Complications

Bracing devices may cause skin irritation. Limb length discrepancies may persist despite appropriate treatment.

Untreated, hip dysplasia will lead to arthritis and deterioration of the hip, which can be severely debilitating.

Calling your health care provider

Call your health care provider if you suspect that your child's hip is not properly positioned.

Review Date:9/28/2007
Reviewed By:Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.