Congenital hip dysplasia (CDH) has been known since early times and its characteristics have already been described by Hippocrates. The efforts to establish the earliest possible diagnosis and adequate early-stage therapy as well as recommendations for their accomplishment are predominant throughout the history of Paediatrics and Orthopaedics. The consequences of an undiagnosed dislocated hip are horrendous for the babies. In spite of adequate therapy a late diagnosis usually leads to lasting damage and in many cases to severe pain and disability, including osteoarthritis.
It has been estimated that 10% of inserted hip joint pros-theses which are currently being implanted are for treatment of disorders of hip maturation [1] including hip dislocation and hip dysplasia. Although clinical instability examinations according to Ortolani [2] have been introduced and are widely used in practice, it was established at a crucial symposium in Vienna in 1971 that 47% of completely dislocated hip joints were only diagnosed at the end of the fi rst year of age [3]. At that time the authors expressed with resignation: “this development hardly leaves hope that under the given circumstances diagnosis and therapy of hip dys-plasia can be mastered to some extent”.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Graf R. Hip Sonography. Diagnosis and Management of Infant Hip Dysplasia. Springer, Heidelberg. 2006
Ortolani M. Un segno poco noto e sua importanza per la diagnosis precoce de prelussazione congenita dell'anca. Pediatric 1937; 45: 129–36
Meznik F, Slancar P. Ursachen für den verspäteten Behand-lungsbeginn bei angeborenen Hüftdysplasien. Österr Ärztezei-tung 1971; 26/4: 356–58
Graf R. Sonographie der Säuglingshüfte und therapeutische Konsequenzen. Thieme, Stuttgart. 2000
Exner GU. Ultrasound screening for hip dysplasie in neo-nates. J Pediatr Orthop 1988; 8: 656–60
Ganger R, Grill F, Leodolter S. Ultrasound screening of the hip in newborns: results and experience. J Pediatr Orthop 1990; 1: 45–9
Joller R, Waespe B. Sonographie der Säuglingshüfte — erste Ergebnisse eines Screeningprogramms im Kanton Uri. In: Schilt M (Hrsg.), Angeborene Hüftdysplasie und —Luxation vom Neugeborenen zum Erwachsenen. SGUMB-SVUPP-Eigenverlag, Zürich. 1993, pp. 163–9
Katthagen BD, Mittelmeier H, Becker D. Häufi gkeit und stationärer Behandlungsbeginn kindlicher Hüftgelenkslux-ationen in der Bundesrepublik Deutschland. U Orthop 1988; 126: 475–83
Wirth T, Hinrichs F, Stratmann L. Verlaufsbeobachtungen der Inzidenz der Hüftdysplasie nach 14-jähriger Anwendung eines sonographischen Neugeborenenscreenings. In: Reichel H und Krauspe R (Hrsg.), Langzeitergebnisse in der Kinder-orthopädie, Steinkopff Darmstadt. 2003, pp. S111–22
Caterall A. The early diagnosis of congenital dislocation of the hip. J Bone Joint Surg B 1994; 76-B: 515–6
Castelein RM, Sauter AJM. Ultrasound screening for congenital dysplasiea of the hip in newborns its value. J Pediatr Orthop 1988; 8: 666–70
Grill F, Müller D, Hübl M, Hexel M. Presentation at training course for pediatric orthopedic surgeons, Speising orthopedic hospital Vienna 2006; June, 30th
Lewis K, Jones DA, Powel N. Ultrasound and neonatal hip screening: the fi ve-year results of a prospective study in high risk babies. J Pediatr Orthop 1999; 19(6): 760–2
Harke HT. Screening newborns for developmental dysplasia of the hip: the role of sonography. Am J Roentgenol 1994; 162: 399–400
Grill F, Müller D. Ergebnisse des Hüftultraschallscreenings in Österreich. Orthopadie 1997; 26: 25–32
Kries v R, Ihme N, Oberle D, Lorani A, Stark R, Altenhofen L, Niethard FU. Universal ultrasound screening programme for developmental dysplasia of the hip in Germany: impact on the rate of fi rst operative procedures. Lancet 2003; 362: 1883–7
Holen KH, Tegnaander A, Bredland T, Johansen OJ, Saether OD, Eik-Nes SH, Terjesen T. Universal or selective screening of the neonatal hip using ultrasound. A prospective, randomised trial of 15529 newborn infants. J Bone Joint Surg Br 2002; 84-B: 886–90
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Graf, R. (2009). DDH: Diagnosis and Treatment Strategies. In: Bentley, G. (eds) European Instructional Lectures. European Federation of National Associations of Orthopaedics and Traumatology, vol 9. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-00966-2_5
Download citation
DOI: https://doi.org/10.1007/978-3-642-00966-2_5
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-00965-5
Online ISBN: 978-3-642-00966-2
eBook Packages: MedicineMedicine (R0)