Hip dysplasia typically develops before a baby is born, and it is often discovered during a newborn physical exam. If not detected, it may worsen in your child’s early years. While the condition can improve without any treatment as your child grows, 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 to meet your child’s needs so their hips can develop normally. Our goal is to treat hip dysplasia as early as possible to prevent future problems such as hip dislocations and instability, deformities, and early arthritis, which can lead to limping, pain, and difficulty with daily activities.

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Diagnosing Hip Dysplasia in Infants

Anyone can be born with hip dysplasia, but low levels of amniotic fluid in the womb during pregnancy, breech positioning, and a family history can increase your child’s chances of developing the condition. Babies with these risk factors are often referred for an ultrasound of their hips regardless of their screening exam results. That’s because these risk factors or signs of hip dysplasia on their newborn screen may have mild cases that go undetected and progress as babies grow and toddlers begin to walk.

Referral to a Pediatric Orthopaedic Surgeon
Depending on the severity of your child’s condition, test results, and risk factors, they may be referred to a pediatric orthopaedic surgeon who has undergone special training and is skilled in treating children with musculoskeletal disorders like hip dysplasia. 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 and treat families from across the state who come to us for their children’s care.

Determining the Severity of Hip Dysplasia
Our pediatric orthopaedic surgeons will conduct a thorough history and physical exam. Depending on your child’s age, they may undergo 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 hips are 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. 

Our Locations

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

Nonsurgical Hip Dysplasia Treatments

Nonsurgical treatment is typically recommended and is more beneficial when hip dysplasia is diagnosed in babies under a year old. These treatments include bracing and sometimes casting to help keep the hips stable and allow for proper development. For older children or more severe cases, surgery may be recommended if nonsurgical treatments have not been effective. Braces are typically worn 23 to 24 hours per day for six to 12 weeks or until the hips appear stable on ultrasound or X-ray. 

Pavlik Harness

This is the most commonly used brace for hip dysplasia in infants up to six months of age. The flexible Pavlik harness gently encourages and positions your child’s hips to develop in a normal position. Infants usually tolerate the brace well. To make transporting your child easier while they are wearing the device, our trained pediatric staff can loan you a special adaptive car seat.

Hip Abduction Braces

For older or larger patients, the flexible harness may not be strong enough to hold the hips in a proper position. In these cases, hip abduction braces -- also called fixed abduction braces – may be used. These braces are sturdier and gently hold the hips apart in a properly aligned position so they can develop normally.

Hip Dysplasia Surgery

Surgery may be necessary for children six months or older. We understand this can be a stressful 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 dysplasia is detected at a later age, a closed reduction may be required. The surgery is performed under general anesthesia but does not require an incision. During this surgery, your child’s orthopaedic surgeon will inject dye into their hip joint to determine the correct position. Your child will then be fitted for a body cast, known as a spica cast, which they will wear for six to twelve weeks. The cast covers both legs and the lower abdomen. Space is provided to allow for diaper changes and to make sure your child is comfortable. Sometimes, a minimally invasive muscle lengthening procedure may be required to allow the hip to be gently moved into place and to decrease the risk of any complications. Regular monitoring of your child’s progress and periodic changes of spica cast will be part of their follow-up care. 

Open Reduction Surgery

For older children and the most advanced cases, or if closed reduction surgery does not correct your child’s hip dysplasia, open reduction surgery may be recommended. During this procedure, the orthopaedic surgeon removes tissue that may be preventing the hip joint from being properly positioned. They may also repair and tighten loose ligaments. Sometimes it is necessary for a cut to be made through the thigh bone or pelvis to reposition the hips. This procedure is called an osteotomy. As with closed reduction, a spica cast will be worn after this procedure.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 01/24/2023 by