What is Congenital Hip Dislocation?

Congenital hip dislocation, also called developmental dysplasia of the hip (DDH), is a medical condition that occurs due to an abnormality in the formation of the hip joint during early fetal development. This abnormality can result in a baby being born with an unstable or unsteady hip joint. The dislocation may be:

  • Complete: the femoral head is fully separated from the socket
  • Partial: the hip is unstable but not fully dislocated (1)

It is important to note that the term "birth dislocation" is medically inaccurate, as the condition originates during fetal development, not during delivery. The issue may become apparent or worsen as the child grows.

Factors That Increase the Risk of Congenital Hip Dislocation

Although the exact cause is unknown, several factors can increase the likelihood of DDH: (2)

  1. Genetics: A family history of hip dysplasia increases the risk. If a sibling or parent had the condition, the chances of occurrence are higher.
  2. Hormonal Changes: Hormonal changes in the mother near delivery can affect some infants, particularly girls, causing ligament laxity that may increase hip instability.
  3. Fetal Position: Certain positions in the womb, such as breech presentation, can place extra pressure on the hips, increasing the risk.
  4. Gender: Girls are 4 to 5 times more likely to be affected than boys.
  5. Congenital Malformations: Babies with other congenital issues, such as neck stiffness or foot deformities, may have limited space in the uterus, putting extra pressure on the hips.

Symptoms of Congenital Hip Dislocation

Parents may not easily notice symptoms, but doctors can identify signs including: (3)

  • Uneven folds or creases on the legs and buttocks when the legs are extended
  • Apparent difference in leg length
  • Delayed motor development or limited leg movement

When and How to Screen for DDH

Screening for hip dysplasia is an important routine examination after birth:

  • Clinical examination: Performed at birth and repeated at 6–8 weeks.
  • Ultrasound (sonography): Used if risk factors are present or if the clinical exam raises suspicion, especially in the first four months.
  • X-ray imaging: Recommended for children older than 6 months. (4)

Treatment Methods for Congenital Hip Dislocation

Treatment depends on the child’s age and the severity of the condition: (5)

  1. Hip brace (Pavlik harness):
  2. Special braces are used to correct hip positioning while allowing limited leg movement.
  3. Most effective when used before 6 months of age.
  4. Treatment is monitored by the doctor, typically for 6–12 weeks. (5)(6)
  5. Casting (Spica cast):
  6. Used if the Pavlik harness is ineffective or if the child is older than 6 months.
  7. Maintains the hip in a proper position to allow normal joint development. (7)
  8. Surgery:
  9. Indicated for children older than 6 months or cases unresponsive to non-surgical methods.
  10. The procedure repositions and aligns the hip joint.
  11. Post-surgery, the child may require:
  12. A cast to maintain hip positioning
  13. A brace after cast removal
  14. Physical therapy to strengthen hip and leg muscles

For the best care using the latest treatment techniques, consult pediatric specialists at Al Ahli Hospital.





References

  1. Orthoinfo - Developmental Dislocation (Dysplasia) of the Hip (DDH)
  2. Hipdysplasia - Understanding Hip Dysplasia
  3. Healthline - Congenital Hip Dislocation
  4. Nationwidechildrens - How Is Hip Dysplasia Evaluated?
  5. Stanfordchildrens - Developmental Dysplasia of the Hip in Children
  6. Kidshealth - Developmental Dysplasia of the Hip
  7. Pmc.ncbi - Splinting for the non‐operative management of developmental dysplasia of the hip (DDH) in children under six months of age