Developmental Dysplasia of the Hip

One or two babies in every hundred are born with some kind of hip problem.

Developmental Dysplasia of the Hip (DDH) describes a variety of conditions in which the ball and socket of the hip joint do not develop properly. For example, the socket may fail to grow deep enough or the ball may be displaced out of the socket.

Some of these babies will grow out of the problem without any treatment. 

Some babies will need treatment in a Pavlik Harness.

Hip Ultrasound Scans

Ultrasound scans of the hip joint allow the radiology team to measure how deep the hip socket is and how the ball is sitting within the socket.

If the ultrasound scan shows Developmental Dysplasia of the Hip, the radiology team may repeat the scan again in approx. 2 weeks or they may contact the Paediatric Orthopaedic Consultants.

If referred to Orthopaedics, the ultrasound scans will be reviewed and a decision made whether:

  1. Monitor A repeat scan to be completed in approx. 2 weeks – you will hear from the Paediatric Physiotherapy team if this is the plan for your baby. You will then hear from the radiology department with another scanning appointment. 
  2. Treatment required The Paediatric Physiotherapy team will be in touch with you to arrange an appointment to commence Pavlik Harness treatment.

Pavlik Harness Treatment

The harness will keep your baby in a comfortable position which aids the correct growth of the ball and socket joints. It allows some movement of the hip, which also helps it to grow correctly. It is a soft harness.

The harness is worn for 24 hours per day for at least 6-8 weeks (depending on the initial scan results and also how the hips respond to treatment). This is then followed by 6 weeks of a weaning programme. Weaning from the harness means your baby can have an hour out of the harness per day; this time out increases every week with the final week being 12 hours out of the harness. 

Babies tolerate the harness very well. There is minimal distribution to activities such as feeding and nappy changes. During the first part of the treatment your baby is unable to have a bath so they will need to be ‘top and tailed’ with cotton wool and water to stay clean. They will need to wear slightly larger clothes. The physiotherapy team will show you how to manage if a harness is required. 

Appointments whilst in harness

  • Physiotherapy appointments will be fortnightly. 
  • Hip ultrasound scan appointments will be approx. fortnightly. Once a normal hip scan is reported no further scans are required. 
  • There will also be an Orthopaedic Consultant review during harness treatment. 

Useful Contact Details

Physiotherapy: Tel - 0300 6133396 /  Email – fhft.therapies@nhs.net
Radiology: Tel – 0300 6134140

Useful website for further information
www.stepsworldwide.org/conditions/hip-dysplasia-ddh

This leaflet has been devised by the Radiology Team, Paediatric Orthopaedic Consultants and the Paediatric Physiotherapy Team. 

Contact us

If you have any queries relating to this information, please contact the Physiotherapy service.

About this information

Service:
Physiotherapy

Reference:
BB/091

Approval date:
1 May 2026

Review date:
1 May 2029

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Important note 

This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.