Congenital Hip Dislocation
Developmental dysplasia of the hip (congenital hip dislocation) is one of the most common hip joint problems in newborns. It occurs when the hip joint does not form normally, causing the femoral head to be improperly positioned within the hip socket. Early detection is the most important factor in achieving excellent outcomes without the need for surgery.
Case Definition
Definition of the Condition
Developmental dysplasia of the hip (DDH) is a condition where the hip joint is unstable or out of place from birth or within the first few months. The dislocation may be partial (instability) or complete (femoral head out of the socket). The problem develops gradually and may not be noticeable without a specialized examination.
Symptoms and Signs to Watch For
Most cases are not painful, but some signs can be observed, such as:
• Difference in leg length.
• Limited range of hip abduction.
• Clicking sounds when moving the hip.
• Unequal skin folds on the thigh.
• Delayed walking or limping in older children.
Causes and Risk Factors of Hip Dislocation
• Baby’s position in the womb, especially breech.
• Family history of the condition.
• Low amniotic fluid during pregnancy.
• Incorrect swaddling (tight wrapping).
• Girls are more commonly affected than boys.
How It Is Diagnosed
• Clinical examination immediately after birth.
• Hip ultrasound during the first 6 months.
• X-rays for children older than 6 months.
• Assessment of dislocation severity to determine the appropriate treatment plan.
Treatment Options
First: Early Treatment (under 6 months)
• Pavlik Harness: helps reposition the femoral head safely.
• Regular weekly follow-up.
Second: Children 6–18 months
• Closed reduction under anesthesia and hip-to-foot casting.
• Follow-up X-rays to ensure joint stability.
Third: After 18 months or advanced cases
• Surgical intervention to restore the hip joint.
• Pelvic or femoral bone adjustments to achieve better stability.
When Surgery Is Needed
• When harness or closed reduction fails.
• In delayed complete dislocation.
• Presence of pelvic bone deformities.
• Late diagnosis after the first year.
Expectations and Outcomes
• Early treatment provides the best results, with success rates over 95%.
• Neglect may lead to future problems like limping or early hip arthritis.
• Most children treated early live completely normal lives without differences.
Important Tips for Parents
• Ensure hip ultrasound for at-risk newborns.
• Avoid wrapping the baby in a way that tightly adducts the legs.
• Consult the doctor immediately if you notice differences in leg movement or length.
• Adhering to the follow-up program is essential for successful treatment.
Frequently Asked Questions about Developmental Dysplasia of the Hip (DDH)
We fully understand the importance of having all the necessary information to make informed decisions about your health. So, we have compiled the most frequently asked questions about developmental dysplasia of the hip (DDH) in children and provided clear and reliable answers. We hope this section helps you gain a better understanding of the condition.
No, hip dislocation does not heal on its own. Early intervention is very important to prevent future deformities or walking difficulties. The earlier the treatment begins, the better the outcome.
Usually, it does not cause pain, but the child may need a few days to get used to it. It is important to ensure it is fitted correctly and to have regular follow-ups to make sure it is properly positioned and not pressing on the skin.
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