Developmental Dysplasia of the Hip
(DDH; Congenital Dysplasia/Dislocation of the Hip [CDH]; Congenital Dysplasia of the Hip; Congenital Dislocation of the Hip; Congenital Subluxability of the Hip; Congenital Hip Dysplasia; Congenital Hip Dislocation; Congenital Hip Subluxability; Dysplasia of the Hip, Developmental)
- Ball of the thigh is loose inside the cup of the pelvis—makes the hip unstable
- Ball moves easily out of the cup—causing a dislocation of the hip
- Ball and cup do not meet at all
- The cup is improperly shaped
|The Hip Joint|
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- How the baby is positioned in the womb
- Maternal hormones
- Family history of DDH
- Breech birth (feet first), especially in females
- Gender: More common in females than males
- Low levels of amniotic fluid during pregnancy
- Late delivery—birth after 42 weeks of pregnancy
- Birthweight greater than 8 pounds 13 ounces (4 kg)
- Uneven folds in the area of the thigh or hip—may be visible in newborns
- Poor mobility and flexibility when beginning to crawl—around 9 months
- One leg shorter than the other may beginning to stand at 10-11 months
- Limping, lurching, walking on toes, or other unevenness in walk at about 1 year
- A test done by placing the baby on his or her back and checking the height of the knees.
- Looking for uneven folds in the hip or thigh
- Difficulty moving the hip outward
- Ultrasound—in babies less than 4 months old or babies with risk factors but a normal physical exam
- X-rays—in babies older than 3 months
- For newborns: a harness called Pavlik harness to keep the hip in place may be worn for 1-2 months
For babies aged 1-6 months:
- Harness to reposition the hip
- Manual adjustment—the doctor moves bones into proper positions, and then places the baby in a lower body cast
For babies aged six months to two years:
- Manual adjustment
- Hip surgery, then body cast
- For children over two years: hip surgery, then body cast
American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/
American Academy of Pediatrics http://healthychildren.org
Canadian Institute of Child Health http://www.cich.ca
Canadian Paediatric Society http://www.cps.ca
Developmental dysplasia of the hip. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00347 . Updated April 2009. Accessed May 3, 2013.
Developmental dysplasia of the hip. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 25, 2012. Accessed May 3, 2013.
Developmental dysplasia of the hip. Shriners Hospital for Children website. Available at: http://www.shrinershospitalsforchildren.org/CareAndTreatment/Orthopaedics/HipDysplasia.aspx . Accessed May 3, 2013.
Hart ES, Albright MB, Rebello GN, Grottkau BE. Developmental dysplasia of the hip: nursing implications and anticipatory guidance for parents. Orthopaedic Nursing. 2006;25:100-111.
Shorter D, Hong T, Osborn DA. Screening programmes for developmental dysplasia of the hip in newborn infants. Cochrane Database Syst Rev. 2011;9:CD004595.
Stedman’s Medical Dictionary . 28th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005; 599-600.
- Reviewer: Michael Woods, MD
- Review Date: 05/2013 -
- Update Date: 05/03/2013 -