Developmental dysplasia of the hip (formerly called congenital hip dislocation) 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 Bones, Joints, and Muscles.)
In developmental dysplasia 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) (particularly for girls)
Newborns who have other deformation (such as birth defects of the feet or problems with the neck)
Newborns who have close relatives with the defect
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, ultrasounds of the hips are usually done. In infants older than 4 months, x-rays are done.
Even if the doctor is not able to detect the defect, newborns who have risk factors should have ultrasounds 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 so that surgery is not needed 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 double or triple diapers or padded diapers is not effective and should not be done.
