Developmental Dysplasia of the Hip

Abstract

Developmental dysplasia of the hip (DDH) encompasses a spectrum of physical and imaging findings from mild instability to frank dislocation. DDH is usually asymptomatic during infancy and early childhood, making a careful and specific physical examination critical. Primary prevention by assuring that there is not excessively tight swaddling or inappropriate binding of the lower limbs is important regardless of available resources. Since 75% of hip dysplasia occurs in patients with no underlying risk factors, early clinical examination is the foundation for early detection and safe conservative treatement. An early diagnosis markedly improves the prognosis, and health workers caring for newborns and infants at all levels should be trained in screening procedures, which involves mindful performance of the Ortolani maneuver. Simple early treatment with a hip abduction device is safe and effective for the child with hip dysplasia or instability that is developmentally related to newborn laxity and mechanical stress.