Treatment for DDH varies, and includes non-surgical and surgical options. The treatment, if detected early, may take months, and follow-up monitoring is recommended as the child grows.
Non-surgical Treatment
Non-surgical options such as a harness or brace can be instituted when DDH is detected early and reducible.
Newborns
For newborns, a brace known as a Pavlik harness is used to keep the thighbone in its correct position within the hip socket. This allows the joint to mould around the femoral head. The harness must be used under the advisement of a trained doctor with frequent monitoring. In the meantime, parents will be taught how to manage daily activities such as cleaning, changing of diapers and feeding while the baby is wearing the harness.
Older than 6 months
For children who are older than 6 months, or in those whom the use of the harness has failed, a closed reduction and cast may be required. In a closed reduction, the baby’s thigh bone is gently moved into its proper position while the child is under anaesthetic, and a cast (also known as a spica cast) is applied to hold the bones in place. Parents will be taught how to perform the usual tasks of baby care while maintaining the integrity of the cast.
6 months - 18 months
Closed reduction with a body cast is also used to treat DDH in older children. However, they may need to undergo a procedure known as skin traction in which the soft tissues are stretched in preparation for the bones to be positioned.
Surgical Treatment
If a closed reduction is not successful in correcting the DDH, surgery may be advised. There are different types of surgical procedures depending on the age of the patient and the severity of the condition. These range from Open Surgical reduction and casting to procedures which require osteotomy (making cuts in the bone) in order to alter the bony architecture.