Hip Dysplasia in Babies

Hip Dysplasia in Babies

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Children may be born with hip dysplasia or develop it in their early years. It is often discovered during newborn screening. While hip dysplasia can improve as children grow, more severe cases may require bracing or even surgery. As experts who treat hip dysplasia in infants and children, Duke pediatric orthopaedic surgeons recommend a treatment plan that helps your child’s hips develop normally. Our goal is to prevent future problems such as chronic hip dislocations, limping, hip deformity, and pain that can result when unstable, loose hips go untreated. 

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Diagnosing Hip Dysplasia in Infants

Hip dysplasia can develop during fetal development and is typically detected during your child’s newborn screening. In some cases, signs of hip dysplasia develop after birth and are detected as babies grow and toddlers begin to walk.

Referral to a Pediatric Orthopaedic Surgeon
Depending on the severity of your child’s condition, he or she may be referred to a pediatric orthopaedic surgeon who has undergone special training and is skilled in treating musculoskeletal disorders in children. Our pediatric surgeons work with a team of nurses and specially trained pediatric staff who are up-to-date on the latest developments in the field. Families from across the state come to us for their children’s care.

Identifying the Severity of Hip Dysplasia
Our pediatric orthopaedic surgeons will conduct a thorough history and physical exam. They may request imaging tests such as an ultrasound or X-ray to confirm the diagnosis and determine the severity of your child’s hip dysplasia.

Follow-Up Care
After treatment for hip dysplasia, your child will continue to see their pediatric orthopaedic surgeon periodically to ensure their hip is developing properly. This ongoing care is important to identify any future problems that may occur, such as a recurrence of the dysplasia or early arthritis. 

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Duke Health offers pediatric orthopaedic clinics throughout the Triangle. Find one near you.

Nonsurgical Hip Dysplasia Treatments

Nonsurgical treatment is typically recommended and more beneficial when hip dysplasia is diagnosed in babies under six months of age. Surgery may be recommended for more severe conditions and in older children.

Hip Abduction Braces

Hip abduction braces, or fixed abduction braces, gently hold an infant’s hips apart in a properly aligned position for about six to 12 weeks. The brace positions the hips to develop normally.

Pavlik Harness

A Pavlik harness is a flexible harness that gently encourages your child’s hips to develop in a normal position. A harness is typically worn for six to 12 weeks or until the hip appears stable on ultrasound.

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Hip Dysplasia Surgery

Surgery may be necessary for children six months or older. We understand this can be an anxious time for parents. Our orthopaedic surgeons and nurses are available to answer your questions and address any concerns you have. 

Closed Reduction Surgery

If bracing does not work or if the dysplasia is detected at a later age, a closed reduction may be required. This is done under anesthesia. The orthopaedic surgeon will inject dye into the hip joint to determine the optimal position. A minimally invasive muscle lengthening may be required to allow the ball at the top of the thigh bone to sit in the joint with ease. Your child will have to wear a body cast -- the medical term is hip spica cast -- to hold the hip in place for six to 12 weeks following the procedure. Regular monitoring of your child’s progress, and periodic changes of the spica cast, will be part of your child’s follow-up care.

Open Reduction Surgery

Open reduction surgery may be recommended to clear out tissue that may be keeping the ball of the hip out of the socket. It may also be recommended if closed reduction surgery isn’t successful. At the same time, the pediatric orthopaedic surgeon may repair and tighten loose ligaments. If this surgery is required, a cut through the thigh bone (femur) or pelvis to reposition the hip is needed. This procedure is called an osteotomy. A hip spica cast will also be necessary after this procedure.

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Duke Children's Hospital & Health Center is proud to be nationally ranked in nine pediatric specialties.
Reviewed: 05/04/2018