When DDH is detected at birth, it can usually be corrected with the use of a harness or brace. If the hip is not dislocated at birth, the condition may not be noticed until the child begins walking. At this time, treatment is more complicated and with less predictable results.
Nonsurgical treatment dependent on the age of the child
Newborns: The baby is placed in a soft positioning device, called a Pavlik harness, for 1 to 2 months to keep the thigh bone in the socket. This special brace is designed to hold the hip in the proper position while allowing free movement of the legs and easy diaper care. The Pavlik harness helps tighten the ligaments around the hip joint and promotes normal hip socket formation.
1 month to 6 months: Similar to newborn treatment, a baby’s thighbone is repositioned in the socket using a harness or similar device. This method is typically successful, even with hips that are initially dislocated.
6 months to 2 years: Older babies are also treated with closed reduction and spica casting. In most cases, skin traction may be used for a few weeks prior to repositioning the thighbone. Skin traction prepares the soft tissues around the hip for the change in bone positioning. It may be done at home or in the hospital.
6 months to 2 years: If a closed reduction procedure is not successful in putting the thigh bone is proper position, open surgery is necessary. In this procedure, an incision is made at the baby’s hip that allows the surgeon to clearly see the bones and soft tissues.
Older than 2 years: In some children, the looseness worsens as the child grows and becomes more active. Open surgery is typically necessary to realign the hip. A spica cast is usually applied to maintain the hip in the socket.