Developmental Dysplasia of the Hip (Hip Dysplasia and DDH) in Children

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If your baby or child has been diagnosed with developmental dysplasia of the hip (also known as DDH or hip dysplasia), you’ll have concerns and questions about her treatment, recovery, outlook and other issues. It may comfort you to know that at Boston Children’s Hospital, Child and Young Adult Hip Preservation Program we'll provide support every step of the way. Our team has treated a large volume of hip conditions that few pediatric hospitals have ever seen. As a result, we can provide expert diagnosis, treatment and care for every level of complexity and severity of DDH. 

What is Developmental Hip Dysplasia?

Developmental dysplasia (DDH) of the hip is a condition in which the hip joint doesn’t develop normally. DDH occurs on a spectrum of abnormality—ranging from just a minor laxity (looseness) of the ligament that holds the ball in the socket to a complete dislocation, in which the ball is entirely out of the socket. In DDH, the hip socket may be too shallow and/or the ligaments too loose, allowing the ball (head) of the thigh bone (femur) to slip in and out of the socket, partially or completely. The socket and/or the femoral head can be out of position or otherwise not programmed to develop properly. Common signs of DDH include:

•    the leg on the side of the dislocated hip may appear shorter
•    the leg on the side of the dislocated hip may turn outward
•    the folds in the skin of the thigh or buttocks may appear uneven
•    the space between the legs may look wider than normal

If a child who has hip dysplasia remains relatively pain-free, parents may sometimes be tempted to leave their child’s diagnosed condition untreated. But even if a child who has DDH grows to adolescence without developing pain or a limp, it’s inevitable that her untreated dysplastic hip will wear out and become arthritic in adulthood. Parents need to understand that sometimes DDH treatment in childhood is prophylactic (preventive)—to prevent serious hip disease and possible disability later on.

How common is hip dysplasia?

Hip dysplasia is the most common developmental hip deformity in children—and the most common single cause of osteoarthritis of the hip in young and older adults. The condition affects one or two out of 1,000 babies. 

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