Developmental Dysplasia of the Hip (DDH) – Expert Diagnosis & Treatment

Developmental Dysplasia of the Hip (DDH) is a condition where the hip joint does not form properly in infants and young children. In DDH, the ball of the femur (thigh bone) does not fit securely into the hip socket, leading to instability or dislocation of the joint. This condition can range from mild to severe and can affect one or both hips. If left untreated, DDH can lead to pain, arthritis, and other long-term hip problems later in life.

Causes and Risk Factors

The exact cause of DDH is not always known, but several factors can contribute to its development, including:

• Genetic Factors – Family history of hip problems or DDH increases the risk.
• Positioning in the Womb – Breech birth (when the baby is positioned feet-first in the womb) is a common risk factor.
• Other Birth Defects – Certain conditions that affect the baby’s overall development can increase the likelihood of DDH.
• Gender – Girls are more likely to have DDH than boys.

Signs and Symptoms

In infants, DDH may not be immediately noticeable. However, there are several signs and symptoms that may suggest the condition:

• Limited Range of Motion – Difficulty in spreading the legs apart or moving them freely.
• Asymmetry – Uneven skin folds or a difference in leg lengths.
• Limping – Older children with undiagnosed DDH may develop a limp or walk with a waddling gait.
• Hip Pain – Children with severe DDH may experience pain, especially with activity.

Diagnosis of DDH

Early diagnosis of DDH is crucial for effective treatment. Pediatricians routinely check for signs of DDH during newborn and infant well-baby checkups. To confirm the diagnosis, the following tests may be used:

• Physical Exam – The doctor checks for signs like unequal leg lengths, hip click or clunk sounds, and limited movement.
• Ultrasound – An ultrasound can be used to examine the hip joint in infants, particularly in the first few months of life when the bones are not fully developed.
• X-rays – In older children, X-rays are used to assess the position of the femoral head and the hip socket.
• CT or MRI Scans – In more complex cases, advanced imaging may be required to evaluate the joint and surrounding structures.

Treatment Options

Treatment for DDH depends on the age of the child and the severity of the condition. The goal of treatment is to ensure the hip joint develops properly and to avoid complications such as arthritis or chronic pain in adulthood.

Non-Surgical Treatment

• Pavlik Harness – For infants diagnosed with DDH before 6 months of age, a Pavlik harness is the most common treatment. This device holds the baby’s hips in a proper position and allows the hip joint to form correctly. The harness is worn for several weeks to several months, depending on the severity.
• Bracing – In some cases, a different type of brace or splint may be used to position the hip and promote proper development.
• Observation and Monitoring – In mild cases of DDH, close monitoring and periodic follow-up visits may be sufficient to ensure the hip joint develops correctly.

Surgical Treatment

For cases where non-surgical treatments are not effective, or in older children, surgery may be required:

• Closed Reduction – In cases of hip dislocation, the doctor may need to reposition the femoral head into the hip socket under anesthesia. This is typically followed by a cast or brace to hold the joint in place.
• Open Reduction Surgery – If closed reduction is not successful or if the hip joint is severely misaligned, a more invasive procedure may be necessary to reposition the joint and ensure proper stability.
• Osteotomy – In some cases, the bone may need to be reshaped or repositioned to improve the alignment of the hip joint. This may involve cutting and repositioning the pelvic bone or the femur.
• Hip Replacement – In severe cases of DDH that result in hip arthritis or deformities, hip replacement surgery may be necessary, particularly in older children or adults.

Post-Treatment Care and Rehabilitation

After treatment, especially following surgery, rehabilitation and monitoring are essential for ensuring full recovery:

• Physical Therapy – Strengthening exercises and mobility training to promote normal function and prevent stiffness.
• Bracing or Casting – In some cases, a brace or cast may be worn for a period of time following surgery to protect the joint and support healing.
• Regular Follow-ups – Routine check-ups with the orthopedic specialist to monitor the development of the hip joint and ensure proper healing.

Why Choose Expert Care for DDH?

• Early Diagnosis – Timely diagnosis and intervention are key to ensuring the best outcomes. Early treatment can prevent long-term complications.
• Minimally Invasive Techniques – Whenever possible, minimally invasive procedures and braces are used to reduce the need for surgery and promote faster healing.
• Comprehensive Care – From initial diagnosis through rehabilitation, expert pediatric orthopedic care ensures that children with DDH receive the most effective and personalized treatment.

Long-Term Outlook

With early diagnosis and appropriate treatment, most children with DDH can grow up with normal, pain-free hip function. If left untreated, DDH can lead to hip arthritis, chronic pain, or difficulty walking. Early treatment significantly reduces the risk of these complications and supports healthy joint development.

By working with a skilled pediatric orthopaedic specialist, parents can ensure that their child receives the best care for DDH, promoting healthy development and optimal mobility throughout life.