What is Congenital Hip Dysplasia? Diagnosis & Treatment

Written by Medicover Team and Medically Reviewed by Dr Shashivardhan , Orthopedics

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Congenital hip dysplasia is a developmental anomaly present at birth, characterized by an improperly formed hip joint. In a healthy hip joint, the femoral head fits snugly into the acetabulum, the cup-shaped socket in the pelvis. However, in infants with hip dysplasia, the socket is too shallow or distorted, causing the femoral head to slip out of place easily.

What are the Causes of Congenital Hip Dysplasia?

The aetiology of congenital hip dysplasia is multifactorial, encompassing genetic, environmental, and physiological factors.

Some of the leading causes include:

Genetic Predisposition: A family history of hip dysplasia significantly increases the risk in newborns. Specific genetic markers may predispose individuals to joint instability.
Breech Presentation: Infants delivered in a breech position are at a higher risk due to abnormal forces on the hip joint during development and delivery.
Gender: The condition is more prevalent in females, possibly due to hormonal influences that affect ligament laxity.
Firstborn Status: Firstborn children often have a higher incidence due to the tighter uterine space, which may restrict fetal movement.
Swaddling Practices: Certain traditional swaddling techniques that tightly bind an infant's legs can exacerbate hip instability.

What are the Symptoms of Congenital Hip Dysplasia?

Congenital hip dysplasia can be asymptomatic in its early stages, making clinical examination vital for early detection. However, some symptoms may manifest, including:

In Infants

Asymmetrical Thigh Folds: Uneven skin folds on the thighs can be indicative of hip misalignment.
Limited Abduction: Difficulty or resistance when moving the infant's legs outward.
Leg Length Discrepancy: One leg may appear shorter than the other.

In Toddlers

Limping: As the child begins to walk, a noticeable limp may develop.
Waddling Gait: A side-to-side walking pattern due to hip instability.
Hip Pain: Discomfort or pain in the hip region, although less common in early childhood.

When to See a Doctor for Congenital Hip Dysplasia?

Congenital Hip Dysplasia, also known as Developmental Dysplasia of the Hip (DDH), is a condition in which the hip joint develops abnormally, causing instability or dislocation of the hip. Early diagnosis and treatment are essential to promote normal hip development, improve mobility, and prevent long-term complications such as chronic pain, limping, and early arthritis.

If you notice signs of hip instability in your child or experience persistent hip-related symptoms, consult an Orthopedic Doctor for a comprehensive evaluation and specialized care.

One leg appears shorter than the other.
Limited movement or reduced flexibility in one or both hips.
Uneven skin folds on the thighs or buttocks.
A clicking or popping sensation when moving the hip.
Difficulty crawling, standing, or walking at the expected developmental age.
Limping, waddling gait, or walking with an abnormal posture.
Persistent pain in the hip, groin, or thigh.
Hip stiffness or reduced range of motion.
A family history of congenital hip dysplasia or developmental hip disorders.
Abnormal findings during newborn or infant hip screening examinations.

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How is Congenital Hip Dysplasia Diagnosed?

Timely diagnosis of congenital hip dysplasia is crucial to prevent long-term complications. The diagnostic process typically involves:

Physical Examination

Physicians perform specific manoeuvres, such as the Ortolani and Barlow tests, to assess hip stability. These tests involve gentle manipulation of the hip joint to detect dislocation or subluxation.

Imaging Techniques

Ultrasound: Ideal for infants under six months, ultrasound provides detailed images of the hip joint's soft tissues and bony structures.
X-Rays: Used in older infants and toddlers, X-rays offer a clear visualization of the hip's anatomical alignment.

How is Congenital Hip Dysplasia Treated?

The treatment of congenital hip dysplasia aims to ensure the proper development of the hip joint. The approach varies based on the infant's age and the severity of the condition.

Non-Surgical Interventions

Pavlik Harness

The Pavlik harness is a standard first-line treatment for infants under six months. It holds the femoral head in the acetabulum, promoting normal hip development through gentle, sustained positioning.

Closed Reduction and Spica Cast

For infants who do not respond to the Pavlik harness, a closed reduction may be performed. This involves manually repositioning the hip under anaesthesia, followed by immobilization with a spica cast to maintain alignment.

Surgical Interventions

Surgery may be necessary for older infants or when non-surgical methods fail. Common surgical procedures include:

Open Reduction

Open reduction is indicated when closed methods are insufficient. It involves surgically realigning the hip joint and may include reshaping the acetabulum to achieve stability.

Osteotomy

Osteotomy entails cutting and realigning bones around the hip joint to improve stability and function. For optimal results, this procedure is often combined with open reduction.

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How is Congenital Hip Dysplasia Managed?

With early diagnosis and appropriate treatment, many infants with congenital hip dysplasia can achieve normal hip function and development. However, ongoing monitoring is essential to ensure long-term success and detect any potential complications, such as:

Avascular Necrosis: Interruption of blood supply to the femoral head, leading to bone death.
Hip Dysplasia in Adulthood: Some individuals may experience residual hip dysplasia, necessitating further intervention in adulthood.

Follow-Up Care

Regular follow-up visits with an Orthopedic Specialist are crucial to monitor hip development and address any concerns promptly. Rehabilitation exercises and physical therapy may also be recommended to strengthen the hip and surrounding muscles.