Developmental Dysplasia of the Hip (DDH) in Grand Rapids, Michigan

Developmental dysplasia of the hip (DDH), previously called congenital dislocation of the hip (CDH), is a condition where a newborn’s hip joint is dislocated or easily slips out of place. With early diagnosis and treatment, around 95% of babies with DDH can be successfully treated.

In general, DDH:

  • Affects girls more often than boys (about 1 in 600 girls vs 1 in 3,000 boys)
  • Affects the left hip more commonly than the right
  • Can affect one or both hips (dislocation of both hips is not uncommon)

In Grand Rapids, pediatricians and pediatric orthopedic specialists at Spectrum Health Helen DeVos Children’s Hospital, Trinity Health Grand Rapids, and Metro Health work together to screen and treat DDH early, often before families ever notice a problem.

Understanding the Hip Joint

The hip is a “ball and socket” joint:

  • The ball is the rounded top of the femur (thigh bone)
  • The socket is the acetabulum, part of the pelvic bone
  • Strong ligaments and soft tissues hold the ball securely in the socket

In a baby with DDH:

  • The socket is abnormally shallow, so the ball does not sit deeply or securely
  • Loose (slack) ligaments may allow the ball to slide partly out (subluxation) or completely out (dislocation) of the socket

This abnormal position can affect how the hip grows and develops, which is why early diagnosis in Grand Rapids newborns is so important.

Signs and Symptoms of DDH

Many babies with DDH do not show obvious symptoms, which is why routine newborn and infant hip checks are standard at Grand Rapids hospitals and clinics. However, possible signs include:

In Newborns and Young Babies

  • A “clunk” felt or heard when the hip is gently moved (this is the femoral head slipping in or out of the socket)
  • Limited movement of one leg compared to the other
  • Uneven skin folds on the thighs or buttocks (the creases don’t match)
  • Wider space than usual between the legs or in the perineum (the area between the genitals and anus)
  • One knee appearing higher than the other when the hips and knees are bent (Galeazzi sign)

These signs can be subtle, so pediatric providers in Grand Rapids typically check your baby’s hips:

  • Right after birth (in the hospital)
  • At newborn and well-baby visits (for example at 2 weeks, 1 month, 2 months, etc.)

In Toddlers and Older Children

If DDH is not diagnosed until later, symptoms may include:

  • Waddling gait when walking
  • Limping or walking on tiptoe on one side
  • One hip or leg appearing lower or shorter than the other
  • Difficulty keeping up with other children when walking or running

If you notice any of these signs in your child in Grand Rapids, contact your pediatrician or a pediatric orthopedic specialist promptly.

Causes and Risk Factors for DDH

DDH has both genetic and environmental influences. Known risk factors include:

  • Family history

    • About one-third of babies with DDH have a close relative (parent or sibling) who also had DDH

  • Congenital disorders

    • Higher risk in babies with conditions such as cerebral palsy or spina bifida

  • Breech position or breech delivery

    • Being born feet or buttocks first can place extra stress on the hip joints

  • Multiple babies (twins, triplets, etc.)

    • Crowding in the womb can impact hip positioning

  • First-time pregnancy

    • A tighter uterus and birth canal may contribute to a more difficult delivery and increased risk

  • Tight leg wrapping or swaddling

    • Wrapping a baby’s legs straight and tightly together can increase the risk of hip dysplasia and dislocation

In West Michigan, pediatric providers are especially careful to screen babies with these risk factors and may recommend additional imaging, such as hip ultrasounds, even if the physical exam is normal.

Routine Screening for DDH in Grand Rapids

Babies in Grand Rapids are routinely screened for DDH:

  • At birth in local hospitals such as Spectrum Health and Trinity Health Grand Rapids
  • At regular well-child visits with pediatricians or family doctors
  • By specialists (pediatric orthopedists) if any concerns are found

Physical Exam

During the exam, your baby is usually laid on their back. The provider gently:

  • Bends and rotates each leg at the hip
  • Checks for full range of motion
  • Feels and listens for any clicks or clunks
  • Looks for asymmetry in leg length or skin folds

A clearly dislocated hip usually does not move normally and may make a distinct clunk as the femoral head moves in and out of the socket.

Imaging Tests

If DDH is suspected, your provider may order:

  • Hip ultrasound

    • Common in babies under 4–6 months because their bones are still mostly cartilage
    • Shows how well the ball sits in the socket

  • X-rays

    • More useful in older infants and children once the bones have hardened

  • CT scan or MRI

    • Occasionally needed in complex cases or after surgery to confirm hip position

Most imaging for DDH in Grand Rapids is done at major medical centers such as Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health facilities.

Treatment for Newborns and Young Babies

Early treatment offers the best chance for a normal, healthy hip. In Grand Rapids, pediatric orthopedic teams commonly use a Pavlik harness for newborns and young infants.

Pavlik Harness

The Pavlik harness is a soft brace that:

  • Holds the baby’s hips in a flexed and abducted position (knees bent, legs apart)
  • Keeps the ball of the femur centered in the socket
  • Allows the hip socket to deepen and develop correctly as the baby grows

Key points:

  • Effective in over 85% of DDH cases in young babies
  • Typically worn for 6–12 weeks, sometimes longer
  • Most babies tolerate it well and are not distressed by its use
  • Follow-up X-rays or ultrasounds are used to track progress

Your Grand Rapids orthopedic team will show you how to:

  • Put on and adjust the harness
  • Bathe and change your baby safely
  • Watch for any skin irritation or circulation problems

Safe Swaddling and Hip Health

Research shows that tight wrapping with the legs held straight can contribute to hip dysplasia and dislocation. This is especially important to remember in Michigan, where families tend to swaddle and bundle babies more tightly in the colder months.

To protect your baby’s hips:

  • Always allow room for the legs to move freely
  • Your baby’s legs should be able to bend at the hips, with knees apart
  • Avoid swaddling that forces the legs straight down and together

If you’re unsure about safe swaddling, your pediatrician, a maternal–child health nurse, or lactation/parent educators at Grand Rapids hospitals can demonstrate hip-healthy swaddling techniques.

Treatment for Older Babies and Children

If DDH is diagnosed after 6 months of age, treatment is more complex because the hip joint is stiffer and more developed.

Closed Reduction (With Anesthesia)

For some babies:

  • The child is given an anesthetic
  • The orthopedic surgeon manually moves the hip back into the socket (closed reduction)
  • A hip spica cast is applied to hold the hip in place while it heals

Surgery (Open Reduction)

In other cases, especially if DDH is found later (around 1–3 years of age) or if closed reduction is not successful, an operation may be needed:

  • The surgeon makes an incision to directly visualize and reposition the hip
  • Tight tissues may be released, and the socket or femur may be reshaped (osteotomy)
  • A hip cast is applied after surgery to maintain the correct position

Follow-up X-rays are used to ensure the hip remains correctly positioned. These surgeries are commonly performed at regional pediatric centers such as Spectrum Health Helen DeVos Children’s Hospital.

Later Diagnosis of DDH

Sometimes, DDH is not diagnosed until a child is two or three years old. In these cases, parents or caregivers may notice:

  • A distinct waddling gait
  • Limping or walking on tiptoe on one side
  • One hip or leg lower than the other
  • Difficulty with balance or frequent falls

If you notice these signs in your toddler in Grand Rapids, talk with your pediatrician promptly. Early referral to a pediatric orthopedic specialist can still significantly improve long-term outcomes.

Possible Complications of Untreated DDH

Without treatment, DDH can lead to:

  • Chronic hip pain
  • Limping and abnormal gait
  • Knee instability or problems, due to altered leg alignment
  • Nerve injury around the femur
  • Early-onset arthritis (osteoarthritis) in the hip, often in young adulthood

Most babies in Grand Rapids who receive timely and appropriate treatment for DDH:

  • Grow up with normal hip function
  • Participate fully in sports and physical activities
  • Have a low risk of serious long-term problems

However, some may develop mild to moderate arthritis in the affected hip later in life, particularly if the dysplasia was severe or diagnosed late.

DDH and Michigan’s Seasonal Considerations

In West Michigan, including Grand Rapids:

  • Cold winters often lead families to use thicker clothing, blankets, and swaddling
  • Extra layers can inadvertently cause tighter leg wrapping

To protect your baby’s hips during winter:

  • Use sleep sacks or hip-healthy swaddles that allow leg movement
  • Dress in layered clothing rather than tightly wrapping the legs straight
  • Ask your pediatrician or a Grand Rapids public health nurse to review your swaddling technique if you’re unsure

When to See a Doctor in Grand Rapids

Contact your pediatrician or family doctor if you:

  • Notice uneven leg lengths or skin folds
  • Hear or feel a clunk when moving your baby’s hips
  • See your child limping, waddling, or walking on tiptoe
  • Have a family history of DDH
  • Had a breech pregnancy or delivery

Early evaluation can be arranged through:

  • Pediatric clinics at Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health
  • Community health centers and family medicine practices
  • Kent County Health Department and Grand Rapids Public Health resources, which can help connect families to pediatric and orthopedic care

Local Resources for DDH Support in Grand Rapids

If your child is diagnosed with DDH, you can find help and information through:

  • Pediatrician or family doctor – first point of contact for screening and referrals
  • Pediatric orthopedic specialists – for diagnosis, imaging, and treatment
  • Spectrum Health Helen DeVos Children’s Hospital – pediatric orthopedic and rehabilitation services
  • Trinity Health Grand Rapids & Metro Health – orthopedic and imaging services
  • Kent County Health Department / Grand Rapids Public Health – guidance on child health, development, and local resources
  • Maternal and child health nurses – support with safe swaddling, baby care, and follow-up

Key Points About Developmental Dysplasia of the Hip (DDH)

  • Dislocation of one or both hips is not uncommon in DDH
  • In DDH, the hip socket is abnormally shallow, preventing a stable fit of the femoral head
  • Unilateral (one-sided) DDH may show uneven buttock or thigh creases and one knee appearing higher than the other
  • Symptoms in older children can include a waddling gait, one hip lower than the other, limping, and walking on tiptoe
  • Early screening and treatment in Grand Rapids offer excellent outcomes for most children

If you live in the Grand Rapids, MI area and have concerns about your baby’s hips, schedule an evaluation with your pediatrician or a pediatric orthopedic specialist as soon as possible. Early action is the best way to protect your child’s long-term hip health.