Developmental Dysplasia of the Hip
Usually present at birth, this condition makes some babies’ hips dislocate easily.
Developmental dysplasia of the hip (DDH) is a dislocation of the hip joint in a newborn baby. The hip is made of two parts: a rounded head or “ball” and cup-like “socket.” When the socket is too shallow, the ball is loose and can slip out of place (dislocate). This may happen in one or both hips.
The condition is usually present at birth, but it may also develop during a child's first year of life. Hip dysplasia occurs in about 1–1.5 of 1,000 births.
• Low levels of amniotic fluid (the protective liquid that surrounds the unborn baby) during pregnancy.
• Being the first child.
• Being female.
• A breech position at delivery, in which the baby's bottom is down.
• A family history of the disorder.
• Large birth weight.
• Swaddling the baby tightly with the hips and knees straight.
• Uneven skin folds on the thigh or buttocks.
• One or both legs turn outward.
• One leg shorter than the other.
• Lower back is rounded inward.
Treatment
Several treatments are available for DDH. Which is used depends on the age of the baby and the severity of the dysplasia. Even after treatment, a difference in leg lengths may remain. If left untreated, DDH will lead to deterioration of the hip and arthritis.
If hip dysplasia is diagnosed within six months after birth, it is often successfully treated with a brace or harness. The harness keeps the hips in place while allowing the legs to move a bit. It is worn for about two months. If the hip will not stay in position using a harness, a brace made of stiffer material may be used to keep the baby's legs in position.
If the hip continues coming out of place after being harnessed, a body cast may be needed. The doctor puts the ball into the socket and then applies a cast to keep it in place. Casting can be done on newborns up to about age two.
Surgery may be needed to realign the hip. The hip socket may be deepened, or the thigh bone may be shortened. After surgery, a body cast will be put on to hold the thigh bones in place. The cast may be on for up to three months.
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