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Developmental Dysplasia of the Hip

By Simeon A. Boyadjiev Boyd, MD, Professor of Pediatrics and Genetics, Section of Genetics, Department of Genetics, University of California, Davis

The bones in the hip may be incorrectly developed at birth.

In developmental dysplasia of the hip, formerly called congenital dislocation of the hip, the newborn's hip socket and the head of the thighbone (femoral head), which normally form the hip joint, become separated, often because the hip has a socket that is not deep enough to hold the head of the femur. Dysplasia of the hip is more common among

  • Newborns born in a breech presentation (buttocks-first position)

  • Newborns who have other deformities (such as birth defects of the feet or problems with the neck)

  • Newborns who have close relatives with the defect

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. Newborns at high risk of hip dysplasia, especially those born in breech presentation, those born with other deformities, and girls who have a positive family history of developmental dysplasia of the hip, should have ultrasonography of their hips at age 6 weeks.

An imaging test is also needed if the doctor finds any abnormality when examining the infant. In infants younger than 4 months, ultrasonography of the hips can confirm the diagnosis of developmental dysplasia of the hip. In infants older than 4 months, x-rays can be used.

Early treatment of developmental dysplasia of the hip is important to avoid the need for surgery 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. The use of triple diapers (an older treatment) or padded diapers is no longer recommended. If the defect persists past the age of 6 months, surgery to fix the hip in the normal position is usually needed.