Developmental dysplasia of the hip

Find out about developmental dysplasia of the hip (DDH), including how it affects a baby or infant, how it's diagnosed and how it can be treated.

Developmental dysplasia of the hip (DDH) is where your baby's hip joint is loose and can move out of its normal position easily. Treatment usually works well to correct the problem with your baby’s hip.

Developmental dysplasia of the hip (DDH) is not usually painful, so many parents do not realise their baby has it.

DDH is often found during the newborn physical examination.

If it’s not found early there are some symptoms you may notice in your baby, such as:

  • a clicking or popping sound when they move their hips
  • one leg moves differently to the other during things like play and nappy changes
  • their legs are different lengths
  • your baby drags one leg when they crawl or limps when they start walking

Symptoms in older children and adults

Sometimes the symptoms of DDH do not start until late childhood, puberty or adulthood. This can happen if the condition is mild and it's not found and treated at birth.

Symptoms typically include:

  • hip pain
  • pain at the top of your inner thighs (groin pain)
  • a clicking, snapping or popping feeling when you move the affected joint

See a GP if:

  • you think you or your child may have developmental dysplasia of the hip
  • you or your child have hip pain

The leg bone of babies with developmental dysplasia of the hip (DDH) does not fit properly into the space in their hip bone. This means the joint becomes looser and does not move properly.

It can affect 1 or both hips.

It's not clear why DDH happens, but there's a higher chance of your baby having it if:

  • they're a girl
  • someone else in your family has had it
  • they moved into a breech position (lying with their feet upwards) during your pregnancy – you may have been given treatment for this before your baby was born

If a healthcare professional thinks your baby has developmental dysplasia of the hip (DDH), they will refer you to a doctor who specialises in bone problems (an orthopaedic surgeon).

DDH is diagnosed in babies using an ultrasound scan of their hip.

Scanning may be recommended if your baby is more likely to have DDH, but does not have any symptoms.

Older children and adults with suspected hip dysplasia are diagnosed by taking X-rays of their hips. This is because older bones show up more clearly on an X-ray than on an ultrasound.

Developmental dysplasia of the hip (DDH) can sometimes get better by itself, but most babies need treatment.

The most common treatment involves your baby wearing a soft fabric harness (Pavlik harness) that helps gently guide their hip joint into the right position.

The harness will be fitted by a healthcare professional and your baby will need to wear it for 6 to 12 weeks, depending on how severe their DDH is.

It needs to be left on, even during nappy changes and bathing your baby. The hospital will give you advice about how to do this.

Babies can be restless after the harness is fitted, but most get used to it after 2 to 3 days.

Your baby will have several scans to make sure the treatment is working. The harness will also be adjusted by staff as your baby grows.

Other treatments

If the Pavlik harness does not work or your baby is older, they may need to wear a plastic and foam brace. This is called a rigid abduction brace.

Rarely, surgery may be needed to adjust the position of the hip joint so it fits and works better. A temporary cast is placed around the hip joint to help it heal in the correct position.

This is only done if DDH is severe, or if a harness or brace has not worked. 

Sometimes surgery is also used to treat hip problems in older children and adults.

You may find it helpful to get support from other parents and carers with a child who has developmental dysplasia of the hip (DDH).

There is also a charity that offers information and support.

Steps Charity Worldwide

Steps Charity Worldwide offers help and support for anyone affected by childhood lower limb conditions, including DDH.