Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2015; 6(11): 886-901
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.886
Developmental dysplasia of the hip: What has changed in the last 20 years?
Pavel Kotlarsky, Reuben Haber, Victor Bialik, Mark Eidelman
Pavel Kotlarsky, Reuben Haber, Victor Bialik, Mark Eidelman, Pediatric Orthopedic Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa 3109601, Israel
Author contributions: Kotlarsky P, Haber R, Bialik V and Eidelman M contributed to this paper.
Conflict-of-interest statement: None of the authors has any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pavel Kotlarsky, MD, Pediatric Orthopedic Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, POB 9602, Haifa 3109601, Israel. spavelko@gmail.com
Telephone: +972-50-2061740 Fax: +972-4-7774193
Received: June 29, 2015
Peer-review started: July 1, 2015
First decision: August 4, 2015
Revised: September 13, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: December 18, 2015
Processing time: 171 Days and 18.1 Hours
Abstract

Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.

Keywords: Developmental dysplasia; Newborn; Infant; Children; Hip; Developmental dysplasia of the hip

Core tip: Developmental dysplasia of the hip (DDH) is a common and important topic in pediatric orthopedics. Early diagnosis and treatment are critical. Screening for this condition is of utmost importance. The treatment depends on the age at presentation and the amount of dysplasia of the hip. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.