What are the other Names for this Condition? (Also known as/Synonyms)

• Congenital Dislocation of the Hip (CDH)
• Developmental Dislocation of the Hip Joint
• Hip Dysplasia due to Developmental Defect

What is Developmental Dysplasia of the Hip? (Definition/Background Information)

• Developmental Dysplasia of the Hip (DDH) is a condition that affects thousands of children, every year. In this disorder, either the head of the thigh bone chronically slips in and out of the hip joint socket, or sometimes, the connective tissues surrounding the hip joint are stretched or torn
• This condition is a congenital dislocation of the hip that is usually present at birth. Female infants are generally reported to have a higher incidence rate
• Common risk factors associated with Developmental Dysplasia of Hip include being a first born child, breech position during delivery, and a family history of the condition
• The exact cause of this disorder is not known. However, low amniotic fluid levels during pregnancy and delivery of child feet first are some factors that may contribute to DDH
• The signs and symptoms of Developmental Dysplasia of the Hip are shortened limb length on the side of the affected hip, dislocation with reduced movements, and uneven skin folds around the thigh or buttocks
• Arthritis and hip deterioration are potential complications that could develop, if Developmental Dysplasia of the Hip is left untreated. Sometimes, treatment methods, such as braces, can cause skin irritation in children
• Treatment options for this condition depend on age of the affected child. Typically, children diagnosed before 6 months of age are treated with a device called Pavlik harness. Infants older than 6 months might need a Spica cast (body cast). Surgery is an option for still older children
• The prognosis of Congenital Dysplasia of the Hip is generally very good if treated suitably. At the present time, no effective methods or guidelines are available for the prevention of this condition

Who gets Developmental Dysplasia of the Hip? (Age and Sex Distribution)

• Developmental Dysplasia of Hip is a condition generally present since birth
• Female infants have the highest rate of occurrence of the condition
• There is no distinct geographical or racial predilection observed

What are the Risk Factors for Developmental Dysplasia of the Hip? (Predisposing Factors)

Common risk factors associated with Developmental Dysplasia of the Hip include:

• Infant delivery: Infants who are born with feet or buttocks first, instead of head first
• Gender: DDH is 4-times more likely to occur in female infants
• Low fluid levels: Children born to women with decreased levels of amniotic fluid during pregnancy
• Family history of the condition
• First-born children
• Large birth weight of the baby
• Post-term pregnancy: Infants born past the 42 week period of gestation
• Foot deformity: Some noticeable foot deformities present during childbirth increase the risk of Developmental Dysplasia of the Hip
• Maternal diabetes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Developmental Dysplasia of the Hip? (Etiology)

The underlying cause of Development Dysplasia of the Hip is unknown. Some factors that may cause this condition include:

• Low amniotic fluid levels: During pregnancy, women with decreased levels of amniotic fluid are 4-times more likely to give birth to children with this condition
• Infant delivery: Infants delivered feet first are 10-times more likely to develop DDH; such births are known as breech births

What are the Signs and Symptoms of Developmental Dysplasia of the Hip?

In some children, the condition may be asymptomatic. In others, the common signs and symptoms associated with Developmental Dysplasia of the Hip may include:

• Noticeable uneven leg appearance; the leg may be ‘turned out’, which is especially visible after 3 months
• Limited range of motion on the dislocated side of the hip
• The limb appears shortened on the affected hip side
• Uneven folds of skin may be seen on the thigh or buttock
• Walking with a limp (once the child learns to walk), especially walking on the toes on the dislocated or shorter limb side
• Inward rounded lower back, which is visible when the child walks

How is Developmental Dysplasia of the Hip Diagnosed?

For an accurate diagnosis of Developmental Dysplasia of the Hip, a healthcare professional might need information from the following exams and tests:

• Complete evaluation of medical history, along with thorough physical exam
• Maneuvering the hip to listen or feel for clunks
• Maneuvers to dislocate the hip or to place it back in normal position
• Ultrasound of the hip: Ultrasound imaging is usually used to diagnose the disorder in younger infants
• X-ray of the affected hip: X-rays may be used to diagnose the condition in older infants

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Developmental Dysplasia of the Hip?

Common complications associated with Developmental Dysplasia of the Hip include:

• Skin irritation due to an orthopedic bracing device
• Increased risk of arthritis and hip deterioration, if the condition is left untreated

How is Developmental Dysplasia of the Hip Treated?

The treatment for Developmental Dysplasia of the Hip generally depends on the age of the child. 

Non-surgical treatment for Developmental Dislocation of the Hip:

• Pavlik harness: A Pavlik harness is a soft joint positioning device that helps keep the infant’s joint in a fixed and secure position. This orthopedic device is common when treating newborn infants with a hip disorder
• Spica cast: If the Pavlik harness is ineffective or the child is older than six months, a Spica cast may be required to treat the condition. Spica cast is also known as a body cast

Surgical treatment for Developmental Dislocation of the Hip:

• Closed reduction: Closed reduction is a surgical intervention that involves manipulating hip joint back into its anatomic position without surgical exposure of any connective tissue. This procedure is performed under general anesthesia
• Open reduction: Open reduction is a surgical intervention that involves surgically exposing the hip and directly manipulating the hip joint back to its anatomic position. This procedure is also performed under general anesthesia in children over the age of two

How can Developmental Dysplasia of the Hip be Prevented?

Currently, there are no definitive measures or guidelines available for the prevention of Developmental Dysplasia of the Hip. However, the following factors may be considered by the expectant mothers to reduce the risk for DDH:

• Getting good prenatal care
• Eating healthy and generally being physically active through the gestation period
• Overweight individuals should reduce their body mass index (BMI) to a normal range, prior to pregnancy

What is the Prognosis of Developmental Dysplasia of the Hip? (Outcomes/Resolutions)

• If Developmental Dysplasia of the Hip is treated appropriately in a timely manner, the associated prognosis is reported to be excellent
• However, disabling complications may occur if the condition is neglected, or if the treatment is delayed

Additional and Relevant Useful Information for Developmental Dysplasia of the Hip:

Low amniotic fluid levels, also known as oligohydramnios, can be caused by a variety of reasons including placental abnormalities, ruptured membrane, or birth defects.