Developmental Dysplasia of the Hip Home A-Z Health Information Health Library A-Z Developmental Dysplasia of The Hip Overview Developmental dysplasia of the hip (DDH) refers to the abnormal development of the hip joint. It involves a spectrum of conditions, ranging from mild instability to complete dislocation. DDH can affect one or both hips and is more common in women. Symptoms Unequal leg length in newborns and infants.Asymmetry of the thighs or gluteal folds and abnormal movements of the hip joint.In children of walking age, pain on the affected side, limping while walking, and reduced movements of the hip joint. Risk factors Females are more affected than males.The first-born female child is commonly affected.Genetics or family history.Breech position (feet coming out first instead of head) of the foetus during pregnancy and brain injury during or before birth (cerebral palsy). Diagnosis Physical examination of the child by performing tests, such as the Barlow test (to assess whether the hip can be dislocated and can come out from the socket) and Ortolani test (to assess whether the hip can be reduced back after dislocating it), the gait pattern at the walking age, and examination of the spine and knee joints.Ultrasonography is the preferred test in children under 6 months of age.Pelvic radiography (X-ray) is preferred in children above 6 months of age. Treatment Non-surgical treatmentThis is the initial choice of management, especially in the early stages of the disease. Treatment approaches include:Bracing (Pavlik harness) in children aged below 6 months to keep the hip joint reduced.Hip spica cast, which is a form of plaster applied around the hips, pelvis, and occasionally the knees to keep the hips in a reduced position.Surgical treatmentSurgery is considered for irreducible hip dislocation or in cases of late presentation. Procedures include:Open reduction of the hip followed by a cast.Osteotomy by creating a fracture surgically in the pelvis, hips, or both, followed by hip reduction and fixation using plates and screws.Hip replacement is occasionally recommended only for adults who have had dislocation for a prolonged duration.