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Developmental Dysplasia of the Hip in Children
WHAT YOU NEED TO KNOW:
What is developmental dysplasia of the hip (DDH)?
DDH is a condition that prevents parts of your child's hip joints from fitting together correctly.
What increases my child's risk for DDH?
- Loose or stretched ligaments
- Breech delivery
- A family history of DDH or other hip problems
- Being female
- Being a firstborn child
- Low levels of amniotic fluid (fluid that surrounds your baby in the womb) during pregnancy
- Medical conditions such as Ehlers-Danlos or Marfan syndromes
What are the signs and symptoms of DDH?
- Unstable hips that pop in and out with movement
- Extra folds or wrinkles on the thigh
- One leg that is shorter than the other
- Pops and clicks heard or felt when your child moves his hips
- Problems crawling, walking, or moving
How is DDH diagnosed?
Your child's healthcare provider will ask about your child's and your health history. This may include details of your pregnancy. He may also ask if other family members have DDH or hip problems. He will examine the movement of your child's hips.
- An ultrasound uses sound waves to show pictures of your child's hips to check for DDH. Your child may need an ultrasound before he is 6 months old if he at risk for DDH.
- An x-ray, CT, or MRI may be used to see if your child's hipbone is in the right place. Contrast liquid may used to help your child's healthcare provider see the hip joint and the area around it. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.
How is DDH treated?
Treatment of DDH depends on your child's age and how bad the deformity is. The head of your child's femur may need to be put back into the hip socket. This will allow his hip to develop normally and help him walk or move correctly.
- A splint called a Pavlik harness holds the hip in place. This harness makes the head of the femur fit correctly into the hip socket. After a few months of wearing the harness, your child's DDH may be slowly corrected.
- A cast may be needed if your child is already walking when his DDH is diagnosed. Healthcare providers may place him in a cast that covers him from the chest down to his legs or knees. The cast will prevent his hips from moving and allow proper healing.
- Closed reduction is a procedure to realign a deformed bone or bring the hip joint back to its normal position. This is done by moving the hips and femur without opening the skin.
- Surgery and a hip brace may also be used to fix and correct your child's hip problem.
- Traction pulls on the hip or thigh bones to pull them back into place. A pin may be put in your child's bone or cast, and hooked to ropes and a pulley. Weight is hung on the rope to help stretch the soft tissues around the hip bones. This helps the hip fit into the hip socket.
- Physical and occupational therapy may be needed. A physical therapist teaches your child exercises to help him improve movement and strength. An occupational therapist teaches your child skills to help with his daily activities.
Call 911 for any of the following:
- Your child feels lightheaded, short of breath, and has chest pain.
When should I seek immediate care?
- Your child's splint or cast gets damaged or breaks.
- Your child's skin around his toes or hips is blue, cold, or numb.
When should I contact my child's healthcare provider?
- Your child's pain is getting worse, even after he has taken his pain medicine.
- You have questions or concerns about your child's condition or care.
Care AgreementYou have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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