Developmental Dysplasia of the Hip

Home Treatment

Basic home treatment for developmental dysplasia of the hip (DDH) focuses on interacting with your child and keeping him or her comfortable.

If your baby or child is wearing a harness, brace, or cast:

• Talk to your doctor about how to care for the device.
• Check your child's skin around the edges of the device for red areas or blisters. If you find any, contact your doctor for treatment.
• Don't put anything inside the device that might scratch or irritate your child's skin, which can lead to an infection. Also, don't apply ointments or creams to your child's skin without talking to your doctor first.
• Play with and hold your child as usual. In most cases, you should be able to interact with your child normally. You will have to adjust some activities, but keeping him or her stimulated and engaged is important. Simple measures, such as moving your child around to different places in your home throughout the day, can help. Also, keep a variety of toys within his or her reach.
• Take your child for short trips outside the home. He or she can still be safely placed in a carrier, stroller, or car seat. Depending on your child's leg positions, he or she may need a specially designed car seat. Ask your doctor about where to buy or rent one. Usually they are available through hospitals or medical supply houses.

Other home treatment depends on the precise medical intervention used.

Pavlik harness care

Do not remove the harness and do not adjust the straps for the first 3 to 4 weeks of treatment unless your doctor tells you to. The harness holds the joint in the correct position for normal development. Removing the harness may cause the thighbone to move out of position. Later in your child's treatment, the harness may be removed for short periods of time, such as for bathing or for cleaning the harness.

You can put your child's clothing on under the straps to prevent skin irritation. You can also pad the shoulder straps if needed.

Spica cast care

If the cast is made of plaster, turn your child at least every 2 hours for the first 24 to 48 hours to prevent uneven drying of the cast. Although you can use a fan to help the cast dry more quickly, don't use heat because the outside will dry before the inside and may burn your child. When you tap the cast and hear a hollow sound, it is dry.

While your child is in a spica cast:

• Tuck the baby's diaper inside the cast beginning at the child's rear and moving toward the front. Use a smaller size than you would normally and use only disposable diapers. Cut the adhesive tabs off the diaper so that they won't irritate your child's skin. Change the diaper as soon as possible after your child urinates or has a bowel movement. At night, add an extra smaller diaper, sanitary napkin, or adult incontinence pad inside the diaper.
• Place your child's clothing over the cast to prevent food or small toys from getting inside the cast.
• Don't move or lift your child by the bar between the legs.

How do I care for my child in a spica cast?

Traction care

• Make sure the weights are hanging freely.
• Check underneath your child for small toys or bits of food. These can irritate his or her skin.
• Bathe your child once a day.
• Find activities your child can safely do. For example, read to your child or play card games if your child is old enough. If your child is still a baby, you can help keep him or her calm and distracted during traction. Try talking, reading, and singing to keep the baby's attention. Touching and stroking the baby will also help.

Parental feelings and concerns

DDH is a defect in growth and development that is beyond your control. Remind yourself that you did not do anything to cause this condition. Understand that it takes time to manage the frequently shifting emotions that are common when your child is diagnosed with DDH. Also, it is important to have or to find a health professional with whom you feel comfortable talking about any concerns you may have.

Caring for a child with DDH is stressful for parents. Take time to care for yourself to reduce stress and to stay healthy. When you have the energy to function well, you are able to provide the best care for your child.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: May 15, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas S. Renshaw, MD - Orthopedics
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