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Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy

Andreas Roposch1, Liang Q Liu, Fritz Hefti

  • 1Department of Orthopaedic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK. a.roposch@ich.ucl.ac.uk

Clinical Orthopaedics and Related Research
|September 29, 2011
PubMed

Insights

This study identified key criteria for diagnosing developmental dysplasia of the hip (DDH) in infants under 9 weeks. Consensus among international surgeons highlights clinical examination and patient history as crucial for early DDH diagnosis.

Area of Science:

  • Pediatric Orthopaedics
  • Diagnostic Criteria Development

Background:

  • Diagnosing developmental dysplasia of the hip (DDH) in early infancy lacks uniform criteria, potentially delaying diagnosis.
  • Establishing consensus on diagnostic criteria is vital for timely and accurate infant DDH detection.

Purpose of the Study:

  • To achieve global consensus among pediatric orthopaedic surgeons on the most relevant criteria for diagnosing DDH in infants younger than 9 weeks.
  • To standardize the diagnostic approach for early-onset DDH.

Main Methods:

  • Utilized the Delphi technique to survey 261 international orthopaedic surgeons from 34 countries.
  • Identified 212 potential criteria and surveyed professionals to establish consensus on the most important diagnostic factors for infant DDH.
  • Achieved a 75% response rate, indicating strong engagement in defining DDH diagnostic standards.

Main Results:

  • A consensus was reached on 37 most relevant criteria for diagnosing DDH in infants under 9 weeks.
  • Criteria distribution: 27% patient characteristics/history, 35% clinical examination, 30% ultrasound, 8% radiography.
  • High inter-rater reliability (Cronbach alpha of 0.9) confirmed strong consensus among participating surgeons.

Conclusions:

  • Established international consensus on the most relevant criteria for diagnosing DDH in early infancy.
  • Key diagnostic criteria include Ortolani/Barlow test, abduction asymmetry, breech presentation, leg-length discrepancy, and family history.
  • The findings provide a foundation for more consistent and timely diagnosis of DDH in infants.
Abstract

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