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Developmental dysplasia of the hip: diagnosis and management to 18 months
1Professor and Consultant Orthopaedic Surgeon, Department of Child Health, University Hospital Southampton, Southampton, United Kingdom.
Insights
Developmental dysplasia of the hip (DDH) is a hip condition in infants. Early diagnosis and Pavlik harness treatment are successful in most cases, with ultrasound monitoring.
Area of Science:
- Orthopedics
- Pediatric medicine
- Medical imaging
Background:
- Developmental dysplasia of the hip (DDH) is a condition with varying severity, from instability to dislocation.
- Identified risk factors include female sex, breech presentation, and family history.
- Early diagnosis and intervention are crucial for successful outcomes.
Purpose of the Study:
- To outline the diagnostic and treatment spectrum for developmental dysplasia of the hip.
- To emphasize the importance of early detection and management.
- To discuss the role of ultrasound in monitoring treatment effectiveness.
Main Methods:
- Clinical examination for initial assessment.
- Ultrasound imaging as the gold standard for diagnosis and monitoring.
- Pavlik harness as a primary splinting treatment.
Main Results:
- The Pavlik harness achieves success in up to 90% of patients when initiated early.
- Ultrasound is effective for monitoring treatment progress during harness use.
- Late presentation or failed splinting may require surgical intervention.
Conclusions:
- Early diagnosis and treatment of DDH, particularly with the Pavlik harness, yield high success rates.
- Ultrasound plays a vital role in guiding and monitoring DDH treatment.
- Surgical intervention is reserved for complex or late-diagnosed cases.
Abstract:
Developmental dysplasia of the hip represents a spectrum of disease ranging from transient neonatal instability to established dislocation. It is accepted that female sex, breech presentation, and family history are risk factors for the disease. Early diagnosis by clinical examination or ultrasound imaging is emphasized, with splint treatment ideally commencing by 6 weeks of age. Treatment using the Pavlik harness is successful in up to 90% of patients. Ultrasound imaging is the gold standard for monitoring a patient during harness wear. Failed splintage or late presentation usually necessitates surgical intervention depending on the patient's age and the severity of the hip dysplasia and displacement.
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