Hips dysplasia is a medical term refers to a condition where the hip joint does not develop properly, leading to instability or dislocation of the hip joint. This can happen at birth, or later in life.
What causes Hip Dysplasia?
The exact cause is unknown. Hormones, family history and the baby’s position in the womb can affect the hips position and contribute to DDH.
How is DDH managed and treated?
- Safe swaddling techniques.
- Special brace.
- Closed reduction procedure – a procedure where the child is asleep under anesthetic, the hip joint is moved into correct position by the orthopedic surgeon
- Surgery – Only used if the special brace does not work, the condition is severe or diagnosed later in childhood.
What is a Hip Special Brace (Hip Adduction Brace)?
These braces help to keep the hips in a better position for hip development, typically with the legs spread apart. While the brace restricts certain movements, it allows for some activities that your child can roll, sit and even walk.
There are 3 common type of Hip Braces
- Rhino Brace
- Pavilk Harness
- Denis Browne bar
- Spica cast (casting to keep the hips spread apart)
Your orthopaedic specialist will provide recommendations, on how long your child should wear the brace during the day and advice of the course of the treatment.
While it may look a bit overwhelming, adapting to a new brace, it is reassuring to know that early detection and early intervention has great outcome! This means, when treated early, most children will have normal hip joint development and no limitation in the baby’s ability to move and function.
Your orthopaedic specialist will provide recommendations, on how long your child should wear the brace during the day and advice of the course of the treatment.
While it may look a bit overwhelming adapting to a new brace, it is reassuring to know that early detection and early intervention has great outcome! This means, when treated early, most children will have normal hip joint development and no limitation in the baby’s ability to move and function.
A few things you may want to prepare and think about when your child has a hip spica cast/ hip brace
- Clothing – Use normal disposable nappies (usually thinner than cloth nappies). Wear loose-fitting clothes and sleep sacks that do not pull the knees together.
- Car seat – The shape of the brace may push the bottom forward in the car seat, speak to an Occupational Therapist to set up your child in a good position.
- High chair – Choose wide base highchair.
- Positioning in sleep and play.
- Skin – Check your child’s skin to make sure there is no rubbing or redness.
Figure 1 - There are some commercial sleep bags that accommodate a wider hip position.
Figure 2 - It might be a bit tricky when positioning your child into your car seat when wearing a hip brace. Straps must be able to secure properly for safe transport. An Occupational Therapist can support you positioning your child into a car seat properly!
Figure 3 - Baby is encouraged to continue with tummy time when wearing a hip brace.
Figure 4 - Play on the back, with leg supported.
Figure 5 - Sleep with leg supported.
Figure 6 - Look for a highchair with wide base and adjustable straps and those without a center bar.Avoid highchairs with tight or restrictive designs that could impede the brace's function and make your child uncomfortable in it.
Figure 7 - Sitting independantly with hip braces.
Figure 8 - Sitting in a stroller.
There are some commercial sleep bags that accommodate a wider hip position.
It might be a bit tricky when positioning your child into your car seat when wearing a hip brace. Straps must be able to secure properly for safe transport. An Occupational Therapist can support you positioning your child into a car seat properly!
Baby is encouraged to continue with tummy time when wearing a hip brace.
Play on the back, with leg supported.
Sleep with leg supported.
Look for a highchair with wide base and adjustable straps and those without a center bar. Avoid highchairs with tight or restrictive designs that could impede the brace's function and make your child uncomfortable in it.
Sitting independantly with hip braces.
Sitting in a stroller.
Speak to your doctor about adjusting the brace and discuss with your orthotist or occupational therapist to gain information on equipment needs!
For any inquiries, please contact Ruby.
Ruby Wong
Senior Physiotherapist
Ruby supports mobility, strength, and physical development through tailored physiotherapy for kids, teens and young adults with disabilities.
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References
Figure 1 –ergopouch US. (2025). How to use the Hip Harness Swaddle and Sleep Sack. [online] Available at: https://www.ergopouch.com/pages/how-to-use-the-hip-harness-pouch
Figure 2 – flicksandredlips (2019). Hip dysplasia car seats, nappy changes and playtime for a baby in a Pavlik harness – Flicks and Red Lips. [online] Flicks and Red Lips. Available at: https://flicksandredlips.com/2019/01/29/hip-dysplasia-pavlik-harness-nappy-car-seats/
Figure 3 – Alicia (2021). How to Survive (and Thrive!) with a Hip Spica Cast – The Baker Upstairs. [online] thebakerupstairs.com. Available at: https://thebakerupstairs.com/2021/09/how-to-survive-and-thrive-with-a-hip-spica-cast.html
Figure 4 – Alicia (2021). How to Survive (and Thrive!) with a Hip Spica Cast – The Baker Upstairs. [online] thebakerupstairs.com. Available at: https://thebakerupstairs.com/2021/09/how-to-survive-and-thrive-with-a-hip-spica-cast.html
Figure 5 – Alicia (2021). How to Survive (and Thrive!) with a Hip Spica Cast – The Baker Upstairs. [online] thebakerupstairs.com. Available at: https://thebakerupstairs.com/2021/09/how-to-survive-and-thrive-with-a-hip-spica-cast.html
Figure 6 – www.google.com. (2024). Healthy Hips Australia – A camping high chair from Kmart has … [online] Available at: https://images.app.goo.gl/YDSPzQexPtRLqcJE7
Figure 7 – Alicia (2021). How to Survive (and Thrive!) with a Hip Spica Cast – The Baker Upstairs. [online] thebakerupstairs.com. Available at: https://thebakerupstairs.com/2021/09/how-to-survive-and-thrive-with-a-hip-spica-cast.html