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DDH Treatment Options (Developmental Dysplasia of the Hip in Babies and Children)

Developmental dysplasia of the hip (DDH) - spectrum from unstable hip to dislocated hip in babies and children. Affects 1-3% of newborns, girls 4-6x more than boys. Universal newborn screening in Australia. Treatment age-dependent: Pavlik harness 0-6 months (95% success), closed reduction and spica cast 6-18 months, open reduction and pelvic osteotomy 18 months-8 years. Early detection and treatment prevents lifelong hip problems and early arthritis.

📅Last reviewed: January 2026đŸĨBones & Joints

📖What is DDH Treatment Options (Developmental Dysplasia of the Hip in Babies and Children)?

Developmental dysplasia of the hip (DDH) - spectrum from unstable hip to dislocated hip in babies and children. Affects 1-3% of newborns, girls 4-6x more than boys. Universal newborn screening in Australia. Treatment age-dependent: Pavlik harness 0-6 months (95% success), closed reduction and spica cast 6-18 months, open reduction and pelvic osteotomy 18 months-8 years. Early detection and treatment prevents lifelong hip problems and early arthritis.

đŸ”ŦWhat Causes It?

  • Developmental condition where hip joint forms abnormally during pregnancy and early infancy
  • Hip socket (acetabulum) too shallow - femoral head (ball) sits loosely or can dislocate out of socket
  • Ligaments holding hip joint together are too loose (joint laxity)
  • Exact cause unknown - combination of genetic factors, hormonal factors (maternal hormones causing ligament laxity), and mechanical factors (position of baby in womb)

⚠ī¸Risk Factors

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You may be at higher risk if:

  • Female gender (girls 4-6 times more likely than boys - female hormones cause more ligament laxity)
  • Breech presentation (bottom-first position in pregnancy, especially last 4 weeks) - increases risk 10-fold
  • Family history (parent or sibling with DDH) - increases risk 10-fold
  • Firstborn child (less room in uterus, more pressure on hips)
  • Tight swaddling with legs straight (traditional swaddling with legs extended and together increases risk)
  • Oligohydramnios (low amniotic fluid in pregnancy - less room for baby to move)
  • Large birth weight or multiple pregnancy (twins)
  • Other packaging disorders: torticollis (tight neck), metatarsus adductus (curved foot)

🛡ī¸Prevention

  • ✓Hip-healthy swaddling: Never swaddle with baby's legs straight and together. Use swaddles that allow hips to flex up and spread apart. Legs should be free to bend and move inside swaddle.
  • ✓Hip-healthy baby carriers: Use carriers that support spread-squat M-position (baby's knees higher than bottom, legs spread apart). Avoid carriers that hold legs straight and together hanging down.
  • ✓Early detection through screening: All Australian babies screened at birth and 6-8 week check. High-risk babies (breech, family history) should have hip ultrasound at 6 weeks even if exam normal.
  • ✓Prompt treatment if diagnosed: DDH outcomes directly related to age at treatment start. Don't delay hoping it will resolve on its own. Start Pavlik harness as soon as diagnosed (before 6 months ideal).
  • ✓Regular follow-up if treated: Even after successful treatment, follow-up X-rays required: Age 2 years, age 4-5 years, and skeletal maturity (age 14-16). Ensures hip developing normally and no residual dysplasia.