Treatment of Developmental Dysplasia of the Hip
Treatment for DDH depends on the child's age and the severity of the condition. Mild cases may correct themselves in the first few weeks of life. In many cases, however, the pediatrician will refer the child to see a bone specialist (orthopedic surgeon) for treatment.

If baby has an unstable hip that does not get better, a brace called a Pavlik harness will be used to hold the hip in position. This device keeps the femoral head in its socket by holding the knee up toward the child's head. A shoulder harness attaches to foot stirrups to keep the leg elevated. The goal is to keep the femoral head in the hip socket. As a baby grows, this helps the hip joint to develop normally. Treatment with the Pavlik harness lasts about 6 to 12 weeks, and continues until the hip is stable and ultrasound exams are normal.

Pavlik harnesses do not work in children over 6 months old. Kids who are older and continue to have DDH may need one of two types of surgery:

A closed reduction, in which the surgeons gently put the hip back into place after the child is put under anesthesia. Then they put a cast on the body for 3-4 months to hold the bone in position. Doctors prefer this treatment in children under 18 months.

An open reduction, in which the surgeons realign the hip and place the thighbone back into the hip socket. During the procedure, doctors loosen the tight muscles and tissues around the hip joint and then later tighten them once the hip is back in place. This is the best procedure for kids older than 18 months, or in cases when closed reduction doesn't work.

After reaching age 2 or 3, a child might need surgery on the pelvis to deepen the hip socket (if it's too shallow) or to shorten the thighbone or realign it. After surgery, kids need to wear a hip spica cast (a type of body cast that keeps the hips from moving). The cast usually is needed for several months, depending on the child's condition.