What are the symptoms of hip dysplasia?

Often, hip dysplasia is not obvious. Doctors and early childhood nurses will do regular checks to look for hip dysplasia in all babies.

They look for a baby who:

• has uneven skin creases near the buttocks or at the front of the upper leg in the groin
• has legs that are a different length
• doesn’t move their legs normally
• has a turned-out foot

In an older child, they may check to see if they:

• sit or walk late
• lean to one side when standing or walking
• waddle when they walk

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What are the causes of hip dysplasia?

Doctors don’t really know what causes hip dysplasia. Risk factors that increase your child’s chance of developing hip dysplasia include:

• being a first born child
• being in a breech position before birth
• female sex
• a family history of hip dysplasia
• low fluid around the baby in the womb (oligohydramnios)
• a high birth weight (over 4kg)
• clubfoot or neck stiffness (torticollis)

Hip dysplasia can also be caused by wrapping swaddling your baby tightly. If you swaddle your baby, make sure they can bend their hips and knees freely.

When should I see my doctor?

Hip dysplasia is often first noticed on at a routine health check.

Your doctor, midwife or early childhood nurse can check your baby’s hips at any time, but will commonly check your baby’s hips:

• at birth
• one week after birth
• 6 weeks after birth
• 6 months after birth
• when they begin to walk

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How is hip dysplasia diagnosed?

If your doctor, midwife or early childhood nurse thinks your child may have hip dysplasia, they will refer you for an ultrasound of your child’s hips or refer you to a paediatrician.

What treatment will my child need?

Treatment will depend on your baby’s age and how severe the condition is.

Braces

If hip dysplasia is diagnosed at birth, your baby may be recommended a soft brace called a Pavlik harness.

Other braces include the Denis Browne Bar and the Hippo/Rhino Brace. These braces help to keep the hips flexed (with the knees up) and abducted (with the legs apart). This is the best position for the hip joint to develop. Your doctor will discuss with you the recommended brace for your child.

Your orthopaedic specialist will teach you how to care for your child while they are wearing the brace, including:

• how many hours a day your child needs to wear brace
• how to change their nappy and clothes
• how to wash your child
• how to care for their skin

Babies with braces usually have regular hip ultrasounds to check their progress.

Closed reduction procedure

If treatment with a brace isn’t effective, you child may need a procedure known as a ‘closed reduction’, where your child’s hip is moved into the correct position while they are under anaesthetic.

Open reduction surgery

Some babies will need an operation to put the femoral head back into the socket. This is more common if babies are diagnosed after 6 months of age. Sometimes more surgery may also be needed.

Hip spicas

After surgery and sometimes after a closed reduction your child will need a hip spica cast This is a plaster cast that covers your child’s body from the knees to the waist. They may need to be in a hip spica cast for several months.

Your baby’s hips should develop normally after treatment. Your doctor will monitor your child for rare problems such as arthritis.

Complications of hip dysplasia

If left untreated, hip dysplasia can lead to a limp, that can progress over time to painful arthritis. Your child may need surgery to address these issues.

Resources and support

If you think your baby might have hip dysplasia, speak to your doctor.

A Pregnancy, Birth and Baby maternal child health nurse can teach you how to:

• breastfeed your baby in a brace
• wrap your baby so that their legs are able to bend at the hips
• position your baby in the brace
• change your baby’s nappy
• bath your baby while in the brace

Read more about hip dysplasia on the Sydney Children’s Hospital Network.