Developmental Dysplasia of The Hip (DDH) in Babies

What Is Developmental Dysplasia of the Hip (DDH) in Babies?

Developmental dysplasia of the hip (DDH) is a condition that occurs when the hip joints are loose or unstable in babies and young children due to abnormalities in the development of the hip joint. This happens when the hip joint's "ball" is not fitted into the "socket" properly.

The normal hip joint comprises the head of the femur bone, securely held in the acetabulum, a cup-shaped structure in the pelvis. This creates a ball-and-socket joint, stabilised by surrounding ligaments and the joint capsule.

In DDH, the hip socket is too shallow, resulting in inadequate support for the femoral head, causing a laxity in the hip joint.If it completely moves out of the joint, it is called dislocation.

What Are the Symptoms of Developmental Dysplasia of The Hip in Babies?

Infants born with DDH typically do not experience pain or exhibit distress. At times, the symptoms of DDH can be challenging to discern. Nevertheless, if your child has DDH, they may exhibit the following symptoms:

Newborn:

• A shorter leg on the side of the affected hip.
• An abnormal position of the affected leg, often with an outward turn.
• Reduced movement on the affected hip.
• Uneven skin folds over the thighs or buttocks.

For older children:

• Discrepancy in leg length.
• Walking with a noticeable limp.

What Are the Risk Factors of Developmental Dysplasia of The Hip in Babies?

While the exact cause of DDH remains unknown, risk factors that are associated with a higher risk of developing DDH include: 

• Female.
• First-born baby.
• Family history of DDH.
• Breech-birthed babies.

How is Developmental Dysplasia of the Hip Diagnosed in Babies?

As part of the newborn physical screening, your baby's hip joints will be carefully examined within 72 hours of birth and again at 6 to 8 weeks of age.

This involves gently manipulating the hip joints to identify potential issues and ensure the process is comfortable for the baby. If the doctor detects instability in your baby's hip during this examination, they may recommend an ultrasound scan of the hip between 4 and 6 weeks of age to further assess the condition.

If there is a suspicion of hip instability in an infant based on a clinical examination, the doctor may order a hip ultrasound to provide a more thorough assessment of the hip joints for infants under six months old.

In older children, hip X-rays are more beneficial for diagnosing DDH.

How Is Developmental Dysplasia of the Hip in Babies Treated?

The treatment for Developmental Dysplasia of the Hip (DDH) in babies depends on their age.

2 weeks old

• In babies younger than 2 weeks old, a loose hip joint is not always treated immediately. 
• This is because some degree of hip joint laxity is considered normal in newborns, and it may resolve on its own as the baby grows.
• If the doctor detects a loose hip in a newborn, they may choose to monitor the situation closely to determine whether the condition self-corrects or persists over time.

2 weeks to 6 months old

• Pavlik harness
• To maintain the hip joint in a stable position and facilitate normal bone growth.
• Required to wear this harness for a duration of 2 to 3 months.

Older than 6 months old

• May involve a procedure or surgery to reposition the hip joint bones correctly.
• Following the corrective procedure, your child will typically be required to wear a cast for 3 to 4 months. This cast serves the crucial role of maintaining the hip joint in its proper position.
• Closed reduction surgery: The femoral head is gently inserted into the hip socket with minimal incisions made.
• Open reduction surgery: A surgical incision is made in the groin area to allow the surgeon to insert the femoral head into the hip socket.

Can Babies Outgrow Hip Dysplasia Without Treatment?

Infants diagnosed and treated in the first 6 months generally have a favourable outcome. If DDH is diagnosed later in childhood or if it is not effectively managed, children may experience hip joint pain or sustained damage as they grow older.

Book an Appointment at Pantai Hospitals

Early detection of DDH is key to effective treatment. Ensure regular hip screenings for your baby and seek immediate attention if you notice any signs of developmental dysplasia of the hip.

A dedicated and expert team of Paediatric specialists at Pantai Hospital is available for consultation to provide the best care and assistance to patients through screening, diagnosis, and treatment.

Get in touch with us to book an appointment today if you have any concerns or questions about developmental dysplasia of the hip (DDH).

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.