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Hip Dysplasia Claims

Congenital hip dysplasia and developmental dysplasia of the hip (DDH).

A photo of Mrs Swaffield

I am very happy and satisfied with the settlement you achieved for me and the service was excellent and thank you very much

Mrs E.Swaffield
Loughborough

Claiming for hip dysplasia

Congenital hip dysplasia is not an uncommon condition in newborns, where their hips are loose, but in most cases, it can be treated quickly. If it is not the opportunity to eliminate long-term complications arising is lost and it may then also be referred to as developmental hip dysplasia (DDH). If as a result of substandard medical care the warning signs are missed and the opportunity to treat the condition without surgery passes by there is an increased the risk of complications occurring and having a long-term effect into adulthood.

In cases of medical negligence, especially those involving a child you can be left feeling vulnerable, uncertain, and worried about further treatment. We’re here to help those affected by birth injuries, including in cases of congenital hip dysplasia. We work with you to identify where and why the negligence occurred, helping you to take a case forward against those responsible for the sub-standard level of care your child has received. With extensive experience in supporting those affect by medical negligence, we can help guide your congenital hip dysplasia claim from start to finish. We understand how difficult making the decision to claim compensation can be and from the very beginning of the process you can rely on the friendly, professional Your Legal Friend team to fight your corner. 

We’ll take the time to fully understand your claim and how you and your child has been affected by DDH, allowing us to place an accurate value on your personal case. If you want to discuss your child's experience of delay in diagnosis of congenital hip dysplasia with us and consider if we can help take your case forward, you can contact Your Legal Friend today.

Claim time limit for child claims

All medical compensation claims are subject to a three-year time limit, after this point you may be too late to take your case to Court. If the injury was suffered by a child under 18, the three-year time limit does not start until the child’s 18th birthday, so they have until age 21.

However, it is always better to start your child’s investigation early whilst facts are still fresh in your mind and whilst medical records are still easily accessible.

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Our expert team will call you...

Our medical negligence team has years of experience working on a wide variety of birth injury cases so we understand just how difficult a decision it can be to bring a hip dysplasia case.Hip dysplasia claims team

That’s why we are committed to guiding you through every step of the process. We ensure that your claim is handled carefully and professionally by our specialist solicitors, while working alongside medical experts, to guarantee the best results for you.

Our birth injury team is headed by Laura Morgan who has a wealth of experience in leading complicated, high-value hip dysplasia cases.

Laura is recognised within the legal profession as a leader in the field of medical negligence and serious injury compensation. Laura has acted in a wide range of cases over her 17 years of practice and has particular expertise in acting for children who have suffered brain injury due to mismanaged birth or surgical errors, and in managing claims that have resulted in the death of a loved one. Laura has achieved a number of large settlements including £5.4 million for a 7-year-old and £4 million for an 11-year-old child.

Laura’s expertise and dedication to her clients is recognised in the Chambers guide to the Legal Profession in which she was praised for the efficiency of her approach to case handling and described as “tenacious and detail-oriented”.

Laura has been a member of the Law Society Clinical Negligence Panel since 2005 and accredited as a Senior Litigator in the Association of Personal Injury Lawyers (APIL) since 2006. Laura is also a member of the specialist lawyers panel for Action against Medical Accidents (AvMA), the UK’s leading charity committed to patient safety and justice.

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The effects of medical negligence can be devastating for the individual and their families, so securing appropriate compensation for them as quickly as possible is our top priority.

Laura Morgan

Director of Medical Negligence

What our customers say

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“I found the staff to be friendly, helpful, courteous and they kept me well informed on a regular basis”

Mrs. Vora,
Loughborough

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“They acted in a sympathetic and professional manner and resolved my case very efficiently”

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Leeds

  For a confidential chat, call one of our experts today 0151 550 5228

10 simple steps to claim

Step
1
Obtaining your medical records
Step
2
Providing your statement of what happened
Step
3
Minimising your loss
Step
4
Establishing that a breach of duty occurred
Step
5
Estabilishing the effect of the breach of duty
Step
86
Preparing your case for CourtCalculating the value of your claim
Step
7
Proving your loss
Step
68
Calculating the value of your claimPreparing your case for Court
Step
9
Attending the trial in Court
Step
10
Awarding your compensation claim

Your questions... answered

What is hip dysplasia?

Congenital hip dysplasia, also known as developmental dysplasia of the hip (DDH), congenital hip dislocation, or hip dysplasia, happens when the joint of the hip doesn’t properly form during the development stage.

The hip is a ball and socket joint, where the socket of the hip is too shallow or the ‘ball’ of the thigh bone isn’t held tightly in place it can lead to hip joints that are loose or clicky hips in babies. In the most extreme cases of congenital hip dysplasia, the hip can dislocate.

When diagnosed during the early stages, treatment can ensure that there are no lasting problems. There are processes in place in the NHS to ensure that every new-born is examined and any potential issues highlighted. However, it can lead to problems later in life if treatment isn’t delivered and there are instances where medical professionals have missed opportunities to diagnose at earlier stages.

Can I claim if congenital hip dysplasia affected my baby?

Congenital hip dysplasia isn’t a condition that can be avoided but you may be able to make a successful compensation claim if your child didn’t receive the level of care he or she should have. You will need to prove both that they were let down by the healthcare system and that the outcome is worse as a result.

Ways that medical negligence could occur in relation to baby hip dysplasia include:

  • A new-born examination not being conducted during the 72 hours following birth or failure to fully examine the hips during the exam.
  • A follow-up examination between six and eight weeks after birth not being conducted.
  • An ultrasound scan not being ordered if your baby’s hips showed signs of instability at the follow-up appointment.
  • Treatment not being delivered effectively or quickly enough following a diagnosis for DDH.
  • The level of care you and your baby received during treatment being below expected standards.

As well as highlighting that medical negligence has occurred you will need to demonstrate how it has affected your baby. This could include lasting complications of congenital hip dysplasia that affects your child’s movement or the need for further surgery that would have been avoided now or in the future as an adult.

Read less

How much compensation will I get?

Every compensation case is different and this is reflected in the value that’s placed on each claim. When you work with Your Legal Friend, we take the time to understand your child’s case and ensure that the suffering they have endured, and any difficulties they are likely to face in the future, as a result, are fully reflected.

While we can’t tell exactly how much compensation they could receive without first speaking to you, medical negligence claims can be worth hundreds of thousands of pounds. Every year the NHS pays out millions to those affected by negligence when they were relying on the healthcare system.

How long do I have to make a claim?

All medical compensation claims are subject to a three-year time limit, after this point you may be will not be able to take your case to Court. If the injury was suffered by a child under 18, the three-year time limit does not start until the child’s 18th birthday, so they have until age 21.

Most DDH cases are brought for children whilst they are quite young, however, if you as an adult have recently been diagnosed with DDH and are facing hip replacement surgery, as a result, you may still be within time to make a claim. In these circumstances, we will look at the ‘date of knowledge’. This is the date on which you first became aware that you had suffered an injury as a result of substandard medical care. This can be difficult to establish so do please speak to our friendly team who would be happy to advise you, whether you are still in time to bring a claim.

How does congenital hip dysplasia affect the baby?

As new-borns DDH doesn’t affect babies but if it’s not treated during the early months of their lives it can create problems when they begin to move around, especially as they crawl and take their first steps and continue to worsen as they grow up. Hip dysplasia in babies shouldn’t cause pain but, again, if it’s left untreated it can lead to early arthritis developing, causing pain and reduced movement.

What causes congenital hip dysplasia?

Causes of hip dysplasia are not always clear or entirely understood. While it’s not understood why DDH sometimes occurs, the condition has been linked to certain risk factors, including:

  • Family history of childhood hip problems
  • Being born in the breech position
  • Being a twin or a multiple birth
  • Being born before the 37th week of pregnancy
  • Womb conditions, including their only being a small amount of fluid in the womb

Spending a lot of time tightly swaddled, where your baby is wrapped with their legs straight and pressed together, can also mean there’s a risk of slowing the baby’s hip development. As babies’ hips are naturally more flexible following birth, swaddling can be one of the hip dysplasia causes if not done correctly.

Read less

Can congenital hip dysplasia be avoided?

Congenital dysplasia can’t be prevented and nobody is to blame for the condition developing in babies. Shortly following birth, a baby’s hips are naturally more flexible and DDH hip is a relatively common occurrence that doesn’t necessarily mean lifelong complications.

While a displaced hip can’t always be avoided, it should be picked up through routine checks by healthcare professionals responsible for the care of you and your baby. Where this hasn’t occurred due to medical negligence, you may be able to make a claim for compensation. If your baby has been affected by infant hip dysplasia that wasn’t treated, leading to mobility problems or other issues, we’re here to offer you support and advice on how to hold those responsible to account.

What are the symptoms and signs of hip dysplasia in babies?

During your baby’s new-born physical examination, a medical professional will check for hip dysplasia symptoms. They will do this within 72 hours of your baby being born and it involves gently manipulating your baby’s hip joints to see if there are any issues. Another hip examination should be carried out when your baby is between six and eight weeks, to again assess if there are any problems. An examination for hip displacement shouldn’t cause your baby discomfort.

Hip dysplasia baby symptoms that are picked up during the early examinations are generally the hip feeling unstable. It’s often not until later that there are noticeable signs of congenital hip problems, becoming more evident as your child moves around more.

How is congenital hip dysplasia diagnosed?

Most cases of congenital hip dysplasia are picked up very early during the new-born physical examination, which should be carried out within 72 hours of birth. A further examination should be conducted when your baby is between six and eight weeks, allowing for medical professionals to flag up any potential issues when they are most treatable.

Both baby examinations will involve gently manipulating your baby’s hips, it shouldn’t cause any discomfort but will allow those conducting the examination to see how their hips move. If the hips do feel unstable a baby hip scan will usually be recommended. This hip ultrasound will give professionals a better understanding of your baby’s joints and allow them to deliver a diagnosis.

How is congenital hip dysplasia treated?

Once a diagnosis for DDH has been achieved, hip dysplasia treatment may need to be started. In some case, baby hip dysplasia treatment isn’t needed as the baby’s hip can stabilise on its own.

Hip dysplasia baby treatment is often very effective and with early diagnosis, most children affected will develop a full range of movement in their hip, with no lasting effects.

There are a number of different treatment options for hip dysplasia, depending on how quickly the condition is diagnosed and the severity of it.

Pavlik harness

A Pavlik harness is a fabric splint that is used to treat DDH in babies. It’s simply used to secure both of your baby’s hips into a stable position as they develop naturally. It’s often used for several weeks and is worn constantly. Through follow up appointments, health professionals will check your baby’s hips and adjust the Pavlik harness where necessary. It can be challenging to changes your baby’s clothes, nappies, and other routine tasks but you should receive advice and instructions when at the hospital.

Surgery

Hip dysplasia treatment may involve surgery if the condition is missed during the baby’s first months or if a Pavlik harness hasn’t been effective. The most common type of surgery is known as a reduction, this is where the ball of the femur is placed back into the hip socket. It’s a procedure that’s conducted under general anaesthetic and your child will need to wear a cast for at least six weeks following the surgery. The hip will be examined at regular points following the surgery to assess how the hip is stabilising.

Closed reduction and hip spica (for children over 6 months of age) – under local anaesthetic, the hip is correctly repositioned, which is checked by an MRI or CT scan after the procedure. A special cast is applied to keep the hip in the right position and is worn for at least 12 weeks.

Open reduction (for an older child) - an operation to loosen the tendons around the hip and remove any obstacle preventing the hip from moving freely. Once the bones are in a good position, the joint is strengthened.

Other types of surgery

Where the condition is more severe, hip displacement treatment may also require bone surgery, allowing for bone deformities that may have developed to be corrected. If DDH has not been resolved by 18 months, more complicated surgery is required. This involves removing some parts of the bone and joint so that the hip can be kept in the right position.

Read less

What happens if congenital hip dysplasia is not treated?

Hip problems in babies that are left untreated can lead to a limp developing, painful and stiff joints, and hip pain. Due to the instability of the joints, it can make full movement and mobility a challenge if treatment isn’t delivered.

If your child's DDH is not diagnosed and treated early, then early arthritis may develop in the hip joint, which causes pain and reduced movement. The treatment of DDH is more complicated and has a lower chance of success once a child's bones have fully developed.

The longer-term prospects worsen if diagnosis or treatment is delayed until the child has begun to walk. Around a third of hip replacement operations carried out on those under the age of 60 years are the result of DDH which was untreated, unsuccessfully treated, or delayed in treatment.

How does congenital hip dysplasia affect babies as they grow older?

The hip dysplasia baby prognosis is generally very good and most of those affected don’t suffer any lasting effects. As your baby grows and begins to crawl or walk you may notice some restricted movement, such as a limp when walking or one leg dragging behind the other. Even if DDH isn’t diagnosed until your child is a toddler, treatment can be used to effectively treat the condition.

How often does congenital hip dysplasia occur?

It isn’t possible to prevent congenital hip dysplasia and one or two babies in every 1,000 born require treatment for the condition. More babies are born with DDH than these figures suggest, however, not every baby that has congenital hip dysplasia requires treatment, as the issue can correct itself.

What are the statistics on congenital hip dysplasia?

Globally around one in every 20 full-term babies has some hip instability at birth. In most cases, the hips will stabilise themselves. Just two or three infants out of 1,000 births will need treatment for congenital hip dysplasia. It’s also more common in girls and first children.

  • 1 in 1,000 babies are born with a dislocated hip
  • Around 2 in 10 cases of DDH affect both hips
  • Around 6 in 10 cases of DDH occur in first-born children
  • 1 in 3 newborns have some degree of instability of the hip
  • Around 8 in 10 cases of DDH are female

What is developmental dysplasia of the hip?

Developmental dysplasia of the hip (DDH) - previously known as congenital dislocation of the hip (CDH) -  is one of several types of abnormality.  It is specifically related to the way that the hip joint develops and is present at birth.  It occurs when the bones which make up the hip joint (the femur and the acetabulum) develop abnormally, causing significantly impaired function of the joint itself.

Certain factors increase the likelihood of an infant developing DDH. For instance, it is more commonly found in females and firstborn children. Babies born prematurely or in the breech position are often more vulnerable, while other complications during pregnancy or delivery can also increase the risk of DDH.

Unfortunately, there are very few visible symptoms of the condition in newborn infants, which sometimes makes prompt diagnosis difficult. However, there are a few indicators of DDH that should be checked for. One femur may appear shorter than the other, or the skin folds between an infant’s legs and torso may appear to be higher on one side. Infants who show signs of DDH should be given regular scans in the weeks after birth.

The abnormality is found in the ‘ball and socket’ joint of the hip, either in the:

  • The shape of the head of the ‘ball’ (the round top of the thigh bone) or
  • The shape of the ‘socket’ (round, cup-like structure within the pelvis) in which the head of the ‘ball’ sits or
  • Supporting structures

When a ball and socket are not in close contact there are two levels of abnormality:

  • Subluxation- a mild abnormality where there is some contact between ball and socket
  • Dislocation- a severe abnormality where there is no contact between ball and socket.
Read less

Is developmental dysplasia of the hip treatable?

Thankfully, the success rate of treating DDH is very high, as long as diagnosis occurs early enough. In cases of delayed diagnosis, however, treatment becomes more difficult and complicated due to the child’s bones having developed further. The rate of successful treatment is significantly lower in these cases, which often causes problems for the child (pain, reduced mobility, arthritis) in later life.

What are the causes of developmental dysplasia of the hip (DDH)?

The causes of DDH can be unclear and are not entirely understood.  However, there are several risk factors known to doctors, clinicians and health visitors, which contribute to the likelihood of a baby being born with DDH.  These are:

Family history - a baby is five times more likely to have DDH if a parent, brother or sister was born with the same condition.

Gender - the female hormone, oestrogen, made by the unborn female baby, can cause the ligaments to relax and be more pliable during labour and could make the bones more likely to move out of position.

Womb conditions – the risk of developing DDH is increased if the baby is not able to move about as much; in more than half of first pregnancies when the womb is tight or if there is only a small amount of fluid in the womb.

Abnormal positioning – an unborn baby has a risk of DDH seven times higher if it is in the breech position (feet down in the womb) or if the knees extend out with the feet near the head.

DDH in the left hip - the most common type of DDH affecting the left hip is thought to be caused by the majority of unborn babies who lie against the mother's spine on their left side. The position may put more pressure on the left hip, increasing the risk of abnormal development.

Other risk factors - include cerebral palsy, spinal cord problems or other nerve and muscle disorders, such as an inward curving of the foot. DDH is also more common in premature babies or babies born weighing more than 5 kg.

Swaddling - following birth, a newborn can be too tightly swaddled around the hips. A baby should have sufficient room for movement with hips and knees bent slightly and turned out.

Read less

How is DDH diagnosed?

A baby should be examined for DDH:

  • Within 24 hours of birth
  • At a 6-week check
  • Between 6-9 months
  • At walking age

A newly born baby with DDH will not show signs of distress or appear to be in pain.

Soon after birth, most babies should be examined by a hospital doctor to detect for signs of DDH.  When DDH is suspected the hospital may advise you to return for a further examination.

Often, newborn babies have an unstable hip at birth caused by soft and lax tissues, which becomes stable by itself as the soft tissues tighten over a period of between 6-8 weeks. Sometimes, just by examining a newborn baby's hips, a slightly dislocated hip can be relocated into the correct position and made stable.

The doctor will bend the baby's knees and turn the thighs outwards to feel for a ‘clunk’, which may indicate that there is a problem with the hip. Two other signs of a hip problem are:

  • Unequal skin folds between the legs – which also occur in around 1 in 4 of normal babies
  • Body may not be equal on both sides
  • Thigh bone may look shorter on one side.

Older children: Children with DDH who have started walking may have a noticeable limp and also walk on their toes. If instability persists, then further tests should be carried out:

At 4-6 months – ultrasound scan, which uses sound waves to construct a picture of structures in the body, routinely carried out on women early in their pregnancy.

Over 4-6 months - an X-ray picture of the pelvis and thigh bone.

Read less

Congenital hip dysplasia, also known as developmental dysplasia of the hip (DDH), congenital hip dislocation, or hip dysplasia, happens when the joint of the hip doesn’t properly form during the development stage.

The hip is a ball and socket joint, where the socket of the hip is too shallow or the ‘ball’ of the thigh bone isn’t held tightly in place it can lead to hip joints that are loose or clicky hips in babies. In the most extreme cases of congenital hip dysplasia, the hip can dislocate.

When diagnosed during the early stages, treatment can ensure that there are no lasting problems. There are processes in place in the NHS to ensure that every new-born is examined and any potential issues highlighted. However, it can lead to problems later in life if treatment isn’t delivered and there are instances where medical professionals have missed opportunities to diagnose at earlier stages.

Congenital hip dysplasia isn’t a condition that can be avoided but you may be able to make a successful compensation claim if your child didn’t receive the level of care he or she should have. You will need to prove both that they were let down by the healthcare system and that the outcome is worse as a result.

Ways that medical negligence could occur in relation to baby hip dysplasia include:

  • A new-born examination not being conducted during the 72 hours following birth or failure to fully examine the hips during the exam.
  • A follow-up examination between six and eight weeks after birth not being conducted.
  • An ultrasound scan not being ordered if your baby’s hips showed signs of instability at the follow-up appointment.
  • Treatment not being delivered effectively or quickly enough following a diagnosis for DDH.
  • The level of care you and your baby received during treatment being below expected standards.

As well as highlighting that medical negligence has occurred you will need to demonstrate how it has affected your baby. This could include lasting complications of congenital hip dysplasia that affects your child’s movement or the need for further surgery that would have been avoided now or in the future as an adult.

Read less

Every compensation case is different and this is reflected in the value that’s placed on each claim. When you work with Your Legal Friend, we take the time to understand your child’s case and ensure that the suffering they have endured, and any difficulties they are likely to face in the future, as a result, are fully reflected.

While we can’t tell exactly how much compensation they could receive without first speaking to you, medical negligence claims can be worth hundreds of thousands of pounds. Every year the NHS pays out millions to those affected by negligence when they were relying on the healthcare system.

All medical compensation claims are subject to a three-year time limit, after this point you may be will not be able to take your case to Court. If the injury was suffered by a child under 18, the three-year time limit does not start until the child’s 18th birthday, so they have until age 21.

Most DDH cases are brought for children whilst they are quite young, however, if you as an adult have recently been diagnosed with DDH and are facing hip replacement surgery, as a result, you may still be within time to make a claim. In these circumstances, we will look at the ‘date of knowledge’. This is the date on which you first became aware that you had suffered an injury as a result of substandard medical care. This can be difficult to establish so do please speak to our friendly team who would be happy to advise you, whether you are still in time to bring a claim.

As new-borns DDH doesn’t affect babies but if it’s not treated during the early months of their lives it can create problems when they begin to move around, especially as they crawl and take their first steps and continue to worsen as they grow up. Hip dysplasia in babies shouldn’t cause pain but, again, if it’s left untreated it can lead to early arthritis developing, causing pain and reduced movement.

Causes of hip dysplasia are not always clear or entirely understood. While it’s not understood why DDH sometimes occurs, the condition has been linked to certain risk factors, including:

  • Family history of childhood hip problems
  • Being born in the breech position
  • Being a twin or a multiple birth
  • Being born before the 37th week of pregnancy
  • Womb conditions, including their only being a small amount of fluid in the womb

Spending a lot of time tightly swaddled, where your baby is wrapped with their legs straight and pressed together, can also mean there’s a risk of slowing the baby’s hip development. As babies’ hips are naturally more flexible following birth, swaddling can be one of the hip dysplasia causes if not done correctly.

Read less

Congenital dysplasia can’t be prevented and nobody is to blame for the condition developing in babies. Shortly following birth, a baby’s hips are naturally more flexible and DDH hip is a relatively common occurrence that doesn’t necessarily mean lifelong complications.

While a displaced hip can’t always be avoided, it should be picked up through routine checks by healthcare professionals responsible for the care of you and your baby. Where this hasn’t occurred due to medical negligence, you may be able to make a claim for compensation. If your baby has been affected by infant hip dysplasia that wasn’t treated, leading to mobility problems or other issues, we’re here to offer you support and advice on how to hold those responsible to account.

During your baby’s new-born physical examination, a medical professional will check for hip dysplasia symptoms. They will do this within 72 hours of your baby being born and it involves gently manipulating your baby’s hip joints to see if there are any issues. Another hip examination should be carried out when your baby is between six and eight weeks, to again assess if there are any problems. An examination for hip displacement shouldn’t cause your baby discomfort.

Hip dysplasia baby symptoms that are picked up during the early examinations are generally the hip feeling unstable. It’s often not until later that there are noticeable signs of congenital hip problems, becoming more evident as your child moves around more.

Most cases of congenital hip dysplasia are picked up very early during the new-born physical examination, which should be carried out within 72 hours of birth. A further examination should be conducted when your baby is between six and eight weeks, allowing for medical professionals to flag up any potential issues when they are most treatable.

Both baby examinations will involve gently manipulating your baby’s hips, it shouldn’t cause any discomfort but will allow those conducting the examination to see how their hips move. If the hips do feel unstable a baby hip scan will usually be recommended. This hip ultrasound will give professionals a better understanding of your baby’s joints and allow them to deliver a diagnosis.

Once a diagnosis for DDH has been achieved, hip dysplasia treatment may need to be started. In some case, baby hip dysplasia treatment isn’t needed as the baby’s hip can stabilise on its own.

Hip dysplasia baby treatment is often very effective and with early diagnosis, most children affected will develop a full range of movement in their hip, with no lasting effects.

There are a number of different treatment options for hip dysplasia, depending on how quickly the condition is diagnosed and the severity of it.

Pavlik harness

A Pavlik harness is a fabric splint that is used to treat DDH in babies. It’s simply used to secure both of your baby’s hips into a stable position as they develop naturally. It’s often used for several weeks and is worn constantly. Through follow up appointments, health professionals will check your baby’s hips and adjust the Pavlik harness where necessary. It can be challenging to changes your baby’s clothes, nappies, and other routine tasks but you should receive advice and instructions when at the hospital.

Surgery

Hip dysplasia treatment may involve surgery if the condition is missed during the baby’s first months or if a Pavlik harness hasn’t been effective. The most common type of surgery is known as a reduction, this is where the ball of the femur is placed back into the hip socket. It’s a procedure that’s conducted under general anaesthetic and your child will need to wear a cast for at least six weeks following the surgery. The hip will be examined at regular points following the surgery to assess how the hip is stabilising.

Closed reduction and hip spica (for children over 6 months of age) – under local anaesthetic, the hip is correctly repositioned, which is checked by an MRI or CT scan after the procedure. A special cast is applied to keep the hip in the right position and is worn for at least 12 weeks.

Open reduction (for an older child) - an operation to loosen the tendons around the hip and remove any obstacle preventing the hip from moving freely. Once the bones are in a good position, the joint is strengthened.

Other types of surgery

Where the condition is more severe, hip displacement treatment may also require bone surgery, allowing for bone deformities that may have developed to be corrected. If DDH has not been resolved by 18 months, more complicated surgery is required. This involves removing some parts of the bone and joint so that the hip can be kept in the right position.

Read less

Hip problems in babies that are left untreated can lead to a limp developing, painful and stiff joints, and hip pain. Due to the instability of the joints, it can make full movement and mobility a challenge if treatment isn’t delivered.

If your child's DDH is not diagnosed and treated early, then early arthritis may develop in the hip joint, which causes pain and reduced movement. The treatment of DDH is more complicated and has a lower chance of success once a child's bones have fully developed.

The longer-term prospects worsen if diagnosis or treatment is delayed until the child has begun to walk. Around a third of hip replacement operations carried out on those under the age of 60 years are the result of DDH which was untreated, unsuccessfully treated, or delayed in treatment.

The hip dysplasia baby prognosis is generally very good and most of those affected don’t suffer any lasting effects. As your baby grows and begins to crawl or walk you may notice some restricted movement, such as a limp when walking or one leg dragging behind the other. Even if DDH isn’t diagnosed until your child is a toddler, treatment can be used to effectively treat the condition.

It isn’t possible to prevent congenital hip dysplasia and one or two babies in every 1,000 born require treatment for the condition. More babies are born with DDH than these figures suggest, however, not every baby that has congenital hip dysplasia requires treatment, as the issue can correct itself.

Globally around one in every 20 full-term babies has some hip instability at birth. In most cases, the hips will stabilise themselves. Just two or three infants out of 1,000 births will need treatment for congenital hip dysplasia. It’s also more common in girls and first children.

  • 1 in 1,000 babies are born with a dislocated hip
  • Around 2 in 10 cases of DDH affect both hips
  • Around 6 in 10 cases of DDH occur in first-born children
  • 1 in 3 newborns have some degree of instability of the hip
  • Around 8 in 10 cases of DDH are female

Developmental dysplasia of the hip (DDH) - previously known as congenital dislocation of the hip (CDH) -  is one of several types of abnormality.  It is specifically related to the way that the hip joint develops and is present at birth.  It occurs when the bones which make up the hip joint (the femur and the acetabulum) develop abnormally, causing significantly impaired function of the joint itself.

Certain factors increase the likelihood of an infant developing DDH. For instance, it is more commonly found in females and firstborn children. Babies born prematurely or in the breech position are often more vulnerable, while other complications during pregnancy or delivery can also increase the risk of DDH.

Unfortunately, there are very few visible symptoms of the condition in newborn infants, which sometimes makes prompt diagnosis difficult. However, there are a few indicators of DDH that should be checked for. One femur may appear shorter than the other, or the skin folds between an infant’s legs and torso may appear to be higher on one side. Infants who show signs of DDH should be given regular scans in the weeks after birth.

The abnormality is found in the ‘ball and socket’ joint of the hip, either in the:

  • The shape of the head of the ‘ball’ (the round top of the thigh bone) or
  • The shape of the ‘socket’ (round, cup-like structure within the pelvis) in which the head of the ‘ball’ sits or
  • Supporting structures

When a ball and socket are not in close contact there are two levels of abnormality:

  • Subluxation- a mild abnormality where there is some contact between ball and socket
  • Dislocation- a severe abnormality where there is no contact between ball and socket.
Read less

Thankfully, the success rate of treating DDH is very high, as long as diagnosis occurs early enough. In cases of delayed diagnosis, however, treatment becomes more difficult and complicated due to the child’s bones having developed further. The rate of successful treatment is significantly lower in these cases, which often causes problems for the child (pain, reduced mobility, arthritis) in later life.

The causes of DDH can be unclear and are not entirely understood.  However, there are several risk factors known to doctors, clinicians and health visitors, which contribute to the likelihood of a baby being born with DDH.  These are:

Family history - a baby is five times more likely to have DDH if a parent, brother or sister was born with the same condition.

Gender - the female hormone, oestrogen, made by the unborn female baby, can cause the ligaments to relax and be more pliable during labour and could make the bones more likely to move out of position.

Womb conditions – the risk of developing DDH is increased if the baby is not able to move about as much; in more than half of first pregnancies when the womb is tight or if there is only a small amount of fluid in the womb.

Abnormal positioning – an unborn baby has a risk of DDH seven times higher if it is in the breech position (feet down in the womb) or if the knees extend out with the feet near the head.

DDH in the left hip - the most common type of DDH affecting the left hip is thought to be caused by the majority of unborn babies who lie against the mother's spine on their left side. The position may put more pressure on the left hip, increasing the risk of abnormal development.

Other risk factors - include cerebral palsy, spinal cord problems or other nerve and muscle disorders, such as an inward curving of the foot. DDH is also more common in premature babies or babies born weighing more than 5 kg.

Swaddling - following birth, a newborn can be too tightly swaddled around the hips. A baby should have sufficient room for movement with hips and knees bent slightly and turned out.

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A baby should be examined for DDH:

  • Within 24 hours of birth
  • At a 6-week check
  • Between 6-9 months
  • At walking age

A newly born baby with DDH will not show signs of distress or appear to be in pain.

Soon after birth, most babies should be examined by a hospital doctor to detect for signs of DDH.  When DDH is suspected the hospital may advise you to return for a further examination.

Often, newborn babies have an unstable hip at birth caused by soft and lax tissues, which becomes stable by itself as the soft tissues tighten over a period of between 6-8 weeks. Sometimes, just by examining a newborn baby's hips, a slightly dislocated hip can be relocated into the correct position and made stable.

The doctor will bend the baby's knees and turn the thighs outwards to feel for a ‘clunk’, which may indicate that there is a problem with the hip. Two other signs of a hip problem are:

  • Unequal skin folds between the legs – which also occur in around 1 in 4 of normal babies
  • Body may not be equal on both sides
  • Thigh bone may look shorter on one side.

Older children: Children with DDH who have started walking may have a noticeable limp and also walk on their toes. If instability persists, then further tests should be carried out:

At 4-6 months – ultrasound scan, which uses sound waves to construct a picture of structures in the body, routinely carried out on women early in their pregnancy.

Over 4-6 months - an X-ray picture of the pelvis and thigh bone.

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