The type of surgery required for this condition depends on its severity and the age of the child at presentation. The earlier the problem is picked up the less the need for invasive surgery.
As a guide therefore if the baby is diagnosed within the first 6-8 weeks a simple harness is usually successful. This needs to be worn until the hip is normal on Ultrasound, which can mean 3 to 6 months.
After this time period babies presenting will probably require a closed reduction of the hip This means a general anaesthetic, and manipulation of the hip. This is followed by a hip arthrogram (dye into the joint to visualise congruency of reduction) to check the head is located properly. If this is successful then a hip spica will be applied for 6 weeks and abduction plasters for a further 6 weeks.
Children presenting later may well require open surgery to put the hip into the joint. This is termed open reduction and may also be combined with surgery on the pelvis to correct the underdeveloped socket of the hip (Salter osteotomy).
Complications of DDH surgery
This type of surgery can cause problems which include infection, temporary loss of blood supply to the hip, plaster related problems such as skin sores and hip stiffness. These are quite rare but can occur.
The child is unlikely to walk normally for up to 3 months after having a prolonged period of time in plaster, but this does resolve as the stiffness in the hip resolves. Formal physiotherapy is rarely necessary but again is age dependant.