Developmental Dysplasia of the Hip (DDH) in Babies: Why Early Diagnosis Matters- By Dr. Balaraju Naidu, Robotic Orthopedic Surgeon, ONUS Robotic Hospitals

A baby’s first few months are crucial for healthy growth and development. During this period, the hip joint continues to mature and become more stable. In some infants, however, the hip joint does not develop properly, leading to a condition known as Developmental Dysplasia of the Hip (DDH).

If left untreated, DDH can affect a child’s ability to crawl, stand, walk, and participate in normal physical activities later in life. The good news is that early diagnosis and timely treatment can lead to excellent outcomes, allowing most children to develop healthy hip joints.

In this article, Dr. M. Balaraju Naidu, Robotic Orthopedic Surgeon at ONUS Robotic Hospitals, explains what DDH is, its symptoms, risk factors, diagnosis, treatment options, and why every parent should be aware of this condition.

What is Developmental Dysplasia of the Hip (DDH)?

Developmental Dysplasia of the Hip (DDH) is a condition in which the hip joint does not develop normally.

Normally, the rounded head of the thigh bone (femoral head) fits securely into the hip socket. In babies with DDH:

The hip socket may be shallow.
The femoral head may move loosely inside the socket.
In severe cases, the hip may become partially or completely dislocated.

DDH can affect one or both hips, though the left hip is more commonly involved.

How Does the Hip Joint Normally Develop?

The hip is a ball-and-socket joint.

The ball is the head of the femur (thigh bone).
The socket is part of the pelvic bone.

During infancy, the hip joint is still developing. Proper positioning of the femoral head within the socket helps the socket grow into its normal shape.

If the hip is unstable or dislocated, normal development is affected.

Causes and Risk Factors

The exact cause of DDH is not always known, but certain factors increase the risk.

Common risk factors include:

Family history of DDH
First-born babies
Female babies
Breech presentation during pregnancy
Low amniotic fluid levels
Multiple pregnancies (twins or triplets)
Tight swaddling with legs kept straight

Having one or more risk factors does not necessarily mean a baby will develop DDH, but careful screening is recommended.

Early Signs Parents Should Watch For

DDH may not always cause pain in babies, making it difficult to recognize without proper examination.

Parents should look for:

Uneven skin folds on the thighs or buttocks
One leg appearing shorter than the other
Difficulty spreading one leg during diaper changes
Limited hip movement
Clicking or popping sensation during hip movement
Uneven leg positioning

As children begin walking, untreated DDH may lead to:

Limping
Walking on toes on one side
Waddling gait
Difficulty running
Hip pain later in childhood

Why Early Diagnosis Is Important

Early diagnosis offers the best chance for successful treatment.

When DDH is detected during the first few months of life:

Treatment is usually simpler.
Surgery can often be avoided.
The hip develops more normally.
Long-term complications are reduced.
Walking and physical development improve.

Delaying treatment increases the likelihood of more complex procedures later.

How Is DDH Diagnosed?

Orthopedic specialists diagnose DDH through:

Physical Examination

Doctors assess:

Hip stability
Range of movement
Leg length
Hip symmetry

Certain gentle clinical tests help identify unstable hips during infancy.

Hip Ultrasound

For babies younger than six months, hip ultrasound is the preferred imaging method.

Ultrasound:

Detects abnormal hip development early
Is painless
Does not use radiation
Helps monitor treatment progress

X-ray

After approximately six months of age, X-rays may be used because the hip bones become more visible.

Treatment Options for DDH

Treatment depends on:

Baby’s age
Severity of DDH
Hip stability
Imaging findings

Pavlik Harness

For young infants, a Pavlik harness is commonly used.

This soft brace:

Holds the hips in the correct position
Encourages normal hip development
Is usually worn continuously for several weeks under medical supervision

Early use often produces excellent results.

Closed Reduction and Hip Cast

If the hip remains dislocated or is diagnosed later, doctors may perform a closed reduction under anesthesia, followed by a hip spica cast.

Surgery

Older children or severe cases may require surgery to:

Reposition the hip
Improve the shape of the hip socket
Restore normal hip stability

Surgical treatment depends on the child’s age and the severity of the condition.

What Happens If DDH Is Left Untreated?

Untreated DDH may result in:

Abnormal walking pattern
Hip pain
Limping
Limited movement
Leg length difference
Early arthritis
Hip instability
Need for complex surgery in adulthood

Early treatment greatly reduces these risks.

Can DDH Be Prevented?

Although DDH cannot always be prevented, parents can reduce risk by:

Avoiding tight swaddling with legs held straight
Allowing babies to keep hips naturally bent and apart
Attending routine pediatric check-ups
Following recommended newborn screening
Seeking evaluation if any hip abnormality is suspected

When Should Parents Consult an Orthopedic Specialist?

Seek medical advice if you notice:

Uneven thigh or buttock folds
One leg shorter than the other
Difficulty moving one leg
Hip clicking
Limited hip movement
Delayed walking
Limping after the child begins walking

Early evaluation provides the best opportunity for successful treatment.

Expert Pediatric Orthopedic Care at ONUS Robotic Hospitals

At ONUS Robotic Hospitals, children with Developmental Dysplasia of the Hip receive comprehensive evaluation using modern diagnostic techniques, including hip ultrasound and orthopedic assessment.

Dr. M. Balaraju Naidu provides individualized treatment plans based on each child’s age and the severity of the condition, ensuring the best possible outcomes for healthy hip development.

Remember:

A small observation today can prevent major problems tomorrow.

About the Doctor

Dr. M. Balaraju Naidu

Founder & Managing Director
Chief Robotic Orthopedic Surgeon
ONUS Robotic Hospitals

Dr. M. Balaraju Naidu specializes in pediatric orthopedic disorders, robotic joint replacement, trauma care, sports injuries, spine disorders, and advanced orthopedic surgery. He emphasizes early diagnosis and evidence-based treatment to help patients of all ages achieve better mobility and long-term musculoskeletal health.

Frequently Asked Questions (FAQs)