Developmental dislocation of the hip (DDH), also known as congenital hip dislocation, dislocatable hip or developmental dysplasia, refers to a range of conditions in which the head (ball) of the hip bone does not fit appropriately into the hip socket at birth.

• The socket may be too shallow
• The ball may move in and out of the socket
• The ball may have come completely out of the socket

No one knows why this happens. It is more common in:

• First born children
• Females
• Breech babies
• Babies with a family history of Hip Dysplasia

It is very important to have a doctor, midwife or Plunket nurse test for this condition within the first few days after your baby is born.

The condition tends to worsen as the child grows and if not treated, may result in the child learning to walk with a limp or unusual waddling gait. As an adult, the condition could cause severe pain, early arthritis and may require hip replacement surgery at a young age. This is what we hope to avoid by treating DDH.

Symptoms are generally not noticeable in infants but may include:

• lack of symmetry to the creases in a baby's thighs, buttocks, groin
• one leg appearing shorter than the other
• one leg appearing less mobile or flexible than the other
• toddler who walks with a limp or waddling gait.

Babies should be screened at birth for DDH by the doctor (or sometimes the midwife) and they will perform certain movements of the baby's hip joint (Ortolani and Barlow tests). If they are suspicious that there could be a problem, then diagnosis can be confirmed by ultrasound scan or X-ray if the baby is more than 4 months old. Sometimes it is dificult to detect hip problems just by examining the baby and that is why tests may be recommended by your GP such as ultrasound or X-ray.

Treatment depends a lot on your child's age and what the ultrasound or X-rays shows us about the hip. There are many different ways to treat DDH. They include:

• Observation with repeat ultrasound or X-rays
• A harness or brace
• Surgery followed by a cast or brace.

It is normal to worry about how the treatment will work for your child. Not all cases of DDH are the same and some are more difficult to treat than others, however the good news is that the majority of cases have a good result from treatment.

Treatment is not always straightforward and it does carry some risk however this will be discussed with you in detail by your Orthopaedic Surgeon and our Nurse Specialist team.

If you are concerned your child may have DDH please see your family doctor. They can refer you to our service if they have concerns. Often an Xray is required before we see your child but this will be discussed with you by your doctor.