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
- 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
- Moving the knees apart—difficulty or limitation with motion indicates a problem
- Ultrasound—in babies less than 4 months old
- X-rays—in babies 4 months and older
- For newborns—a 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 and casting—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 and cast
- 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 Healthychildren.org http://www.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, et al. Developmental dysplasia of the hip: nursing implications and anticipatory guidance for parents. Orthopaedic Nursing. 2006;25:100-111.
Shorter D, Hong T, et al. 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.
1/20/2015 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Academy of Orthopaedic Surgeons (AAOS). American Academy of Orthopaedic Surgeons clinical practice guideline on detection and nonoperative management of pediatric developmental dysplasia of the hip in infants up to six months of age. Rosemont (IL): American Academy of Orthopaedic Surgeons (AAOS); 2014 Sep 5. 368. Available at: http://www.guideline.gov/content.aspx?id=48516#Section420. Accessed January 20, 2015.
- Reviewer: Michael Woods, MD
- Review Date: 02/2014 -
- Update Date: 01/20/2015 -
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