Developmental dysplasia of the hip is a birth defect in which the bones in the hip are incorrectly developed.
Birth defects, also called congenital anomalies, are physical abnormalities that occur before a baby is born. "Congenital" means "present at birth." (See also Introduction to Birth Defects of the Face, Bones, Joints, and Muscles.)
In developmental dysplasia of the hip, formerly called congenital dislocation of the hip, the newborn's hip socket and the head of the thighbone (femoral head), which form the hip joint, become separated, often because the hip socket is not deep enough to hold the head of the femur. Dysplasia can affect one or both hips.
Risk factors for dysplasia of the hip include the following:
Newborns born in a breech presentation (buttocks-first position)
Newborns who have other deformities (such as birth defects of the feet or problems with the neck)
Newborns who have close relatives with the defect (particularly for girls)
Diagnosis of Developmental Dysplasia of the Hip
Imaging tests
All newborns are screened for developmental dysplasia of the hip. The doctor may be able to detect the defect by moving the newborn's hips through a series of specific movements. The right and left legs or hips often look different from each other in affected newborns.
An imaging test is needed if the doctor finds any abnormality when examining the infant. In infants younger than 4 months, ultrasonography of the hips is usually done. In infants older than 4 months, x-rays can be used.
Even if the doctor is not able to detect the defect, newborns who have risk factors should have ultrasonography of their hips at age 6 weeks.
Treatment of Developmental Dysplasia of the Hip
Pavlik harness
Early treatment of developmental dysplasia of the hip is important to avoid the need for surgery later. The best treatment is early use of the Pavlik harness. The Pavlik harness is a soft brace that holds the infant's knees spread outward and up toward the chest.
If the defect persists past the age of 6 months, surgery to fix the hip in the normal position is usually needed.
The use of triple diapers (an older treatment) or padded diapers is no longer recommended.
