Hip dysplasia (developmental dysplasia
of the hip) is a condition in which a child's upper thighbone is
dislocated from the hip socket. It can be present at birth or develop during a
child's first year of life.
Hip dysplasia is not always detectable at birth
or even during early infancy. In spite of careful screening of children for hip
dysplasia during regular well-child exams, a number of children with hip
dysplasia are not diagnosed until after they are 1 year old.
Hip dysplasia is rare. However, if your baby is
diagnosed with the condition, quick treatment is important.
What causes hip dysplasia?
No one is sure why hip dysplasia occurs (or why
the left hip dislocates more often than the right hip). One reason may have to
do with the hormones a baby is exposed to before birth. While these hormones
serve to relax muscles in the pregnant mother's body, in some cases they
also may cause a baby's joints to become too relaxed and prone to
dislocation. This condition often corrects itself in several days, and the hip
develops normally. In some cases, these dislocations cause changes in the hip
anatomy that need treatment.
Who is at risk?
Factors that may increase the risk of hip
Sex—more frequent in girls
Family history—more likely when
other family members have had hip dysplasia
Birth position—more common in
infants born in the breech position
Birth order—firstborn children
most at risk for hip dysplasia
Detecting hip dysplasia
Your pediatrician will check your newborn for
hip dysplasia right after birth and at every well-child exam until your child is
During the exam, your child's
pediatrician will carefully flex and rotate your child's legs to see if
the thighbones are properly positioned in the hip sockets. This does not require
a great deal of force and will not hurt your baby.
Your child's pediatrician also will look
for other signs that may suggest a problem, including
Limited range of motion in either
One leg is shorter than the other
Thigh or buttock creases appear uneven
If your child's pediatrician suspects a
problem with your child's hip, you may be referred to an orthopedic
specialist who has experience treating hip dysplasia.
Treating hip dysplasia
Early treatment is important. The sooner
treatment begins, the simpler it will be. In the past parents were told to
double or triple diaper their babies to keep the legs in a position where
dislocation was unlikely. This practice is not recommended. The
diapering will not prevent hip dysplasia and will only delay effective
treatment. Failure to treat this condition can result in permanent
If your child is diagnosed with hip dysplasia
before she is 6 months old, she will most likely be treated with a soft brace
(such as the Pavlik harness) that holds the legs flexed and apart to allow the
thighbones to be secure in the hip sockets.
The orthopedic consultant will tell you how long
and when your baby will need to wear the brace. Your child also will be examined
frequently during this time to make sure that the hips remain normal and
In resistant cases or in older children, hip
dysplasia may need to be treated with a combination of braces, casts, traction,
or surgery. Your child will be admitted to the hospital if surgery is necessary.
After surgery, your child will be placed in a hip spica cast for about 3 months.
A hip spica cast is a hard cast that immobilizes the hips and keeps them in the
correct position. When the cast is removed, your child will need to wear a
removable hip brace for several more months.
If you have any concerns about your
child's walking, talk with his pediatrician. If the cause is hip
dysplasia, prompt treatment is important.
Copyright © 2003 American Academy of Pediatrics. All rights reserved.