Developmental Dysplasia of the Hip With a Cast: How to Care for Your Child

Developmental dysplasia of the hip (DDH) is a problem with the way a baby's hip joint forms. Sometimes the problem starts before the baby is born, and sometimes it happens after birth, as the child grows. After a baby has a procedure for DDH, a cast helps hold the hip in place. Taking good care of the cast will help the hip heal.

• Check the area around the cast every day. Make sure the skin is not red, rubbed, or scratched and the legs are not cold, blue, or pale.

To prevent the cast from rubbing the skin:

• Keep your child's cast dry:

  • Use leak-proof diapers and change them often.

  • Do not put your child in the bath or shower. Instead, give your child a sponge bath. Use a damp washcloth and a small amount of gentle soap. Reach under the cast edges to clean.

  • If the cast gets splashed, gently blow air into it from a hair dryer on the cool setting.

• Do not use lotions, powders, or creams under the cast.

• Don't let your child scratch under the cast or put anything in it. For itching, tap lightly on the cast or use a hair dryer on the cool setting to blow air in and around the edges.

• Change your child's position often.

Keep appointments:

• After surgery, your baby will see the orthopedic team in the office often to check the hip joint.

• If your child needs a new cast, the doctor might do this in the operating room while medicines keep your child comfortable. The team will work with you to schedule this, if it's needed.

• After treatment, the orthopedic team will see your child about once or twice a year and get X-rays to see how the hip develops. 

• Your child has a fever.

• You think your child has severe pain.

• Your child has cold, blue, or pale legs. 

• The cast causes skin irritation or discomfort.

• The cast seems too tight or too loose.

• The cast gets damaged or very wet, or it has a foul odor.

What causes DDH? DDH is caused by a problem with how the hip joint forms. The hip joint is made of a ball at the top of the thighbone (called the head of the femur) sitting in a socket (the cup-shaped bone called the acetabulum). This structure lets the hip move in lots of directions. 

When a baby has DDH, the ball part of the joint may be completely, or partly, out of the socket. Sometimes the ball part may slide in and out of the socket. Often, the socket is shallow. 

How long does my baby need to wear the cast? Casts usually need to stay on for 3–4 months. After the doctor removes the cast, your child might wear a softer, removable brace for 6–12 weeks. 

Can DDH run in families? Yes. The health care provider may recommend testing for DDH in any children you have in the future. If they have DDH, treatment can start right away.