Each time we walk, sit down, or dance, we have the ball-and-socket hip joint to thank. But about 1 in 1,000 infants is born with a defective joint. In some cases, the socket may be too shallow, allowing the ball to fall out of the joint. This condition is called congenital hip dysplasia or developmental dysplasia of the hip (DDH) and occurs in newborns.

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Most parents and physicians can spot congenital hip dysplasia; one leg may be shorter than the other, or the leg from the dislocated hip may splay outward. The space between the legs may seem wider than usual, giving the child a bow legged appearance, or the folds of fat on the thighs may appear uneven. To diagnose the condition, physicians perform an x-ray, ultrasound, or MRI scan.

Congenital hip dysplasia is caused by both genetic and environmental factors. The condition tends to run in families, and a breech birth may also increase risk. To correct the hip joint, physicians put the ball back into its socket to allow the hip to develop normally. The first method is usually a Pavlik harness, which has two slings to hold the hip in place. The cast is worn around the clock for 6 weeks and then 12 hours a day for another 6 weeks.

If this treatment isn’t successful, a cast, traction, or surgery may be necessary. With traction, a series of pulleys and weights helps stretch the soft tissues around the hip and keep the bones aligned properly. A baby typically remains in traction for 2 weeks, either at home or in the hospital. As a last resort, surgeons can correct the hip and a cast can hold it in place.

ADDITIONAL FACTS

  1. Because the uterus tends to be smallest in a woman’s first pregnancy, firstborn children are more likely to have congenital hip dysplasia.
  2. Girls have a greater chance of developing congenital hip dysplasia than boys do.