Developmental hip dislocation (also called developmental dysplasia of the hip) is a condition in which a child's hip joint does not form properly, so the ball of the thigh bone does not sit securely in its socket and the joint may be loose or dislocated. Dr. Emeel Hourani explains its signs, diagnosis and treatment options in general terms, stressing that a child's bones are still growing and early assessment matters.
Note: This is general information. Your child's condition can only be determined by an in-person examination by a surgeon who treats pediatric orthopedic conditions.
Symptoms
Some signs may appear, though in some cases there may be no obvious sign:
- Legs of different length or knees at different levels
- Uneven skin folds on the thighs
- Less movement in one leg, or difficulty opening it during nappy changes
- A click or a feeling of looseness in the hip
- Late walking, or a limp in an older child
- A swaying, waddling walk
Causes
The exact cause is not always clear, and some general factors may be linked to the condition:
- A family history of the condition
- The baby's position in the womb
- Breech position at birth
- Low amniotic fluid
- Swaddling that keeps the legs tightly straight, which is worth asking your doctor about
Diagnosis
The doctor carefully examines the child's hips and leg movement, and this may be done as part of a newborn check-up. Ultrasound is used for young babies and X-rays for older children to assess the shape and position of the joint.
Early diagnosis can allow simpler treatment, while later diagnosis may need more complex care. The surgeon sets the plan according to the child's age and the condition of the joint.
Treatment options
Non-surgical treatment
In infants, non-surgical treatment may be used to hold the hip in a position that helps the ball stay in its socket, supervised and followed closely by the doctor.
This may include braces or positioning devices made for children, and regular checks to confirm the joint is developing. The surgeon decides which treatment suits each child.
- A brace or harness that holds the hip in a suitable position
- Regular follow-up with examination and imaging
- In some cases, repositioning the joint under anesthesia followed by a cast
Surgical treatment
If non-surgical treatment is not enough, or the condition is found late, surgery may be considered to bring the ball back into its socket, and it can include reshaping the pelvic or thigh bone. The decision depends on the child's age and the condition of the joint, and the surgeon explains it to parents in detail after assessment. For a related procedure, see hip osteotomy.
Recovery and rehabilitation
Recovery time varies from child to child and is set by the surgeon after assessment. Regular follow-up matters because the child is growing, and the hip needs monitoring through the stages of growth.
- Using the brace or cast as the doctor directs
- Skin care and hygiene around the cast
- Regular follow-up with examination and imaging
- Physiotherapy and gradual movement when needed
- Monitoring hip growth as the child gets older
When to see the doctor
Have your child seen by a pediatric orthopedic surgeon if you notice:
- Legs of different length or differently shaped thighs
- Difficulty moving one leg
- A limp or uneven walk
- Late walking
- A family history, or a breech birth, even when there are no symptoms