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Managing Developmental Dysplasia of the Hip

Abstract

Developmental dysplasia of the hip (DDH) involves a spectrum of hip disorders that affect hip anatomy and development and can range from mild anatomical deformity with a reduced but subluxatable hip to a frankly dislocated hip. It was previously known as congenital dislocation of the hip (CDH) but this name is no longer used due to the fact that the hip may be anatomically abnormal whilst not being dislocated. The key aim of clinical management of DDH is early diagnosis and referral as this can often mean less invasive treatment is possible, and outcomes are significantly improved if treatment is initiated at an early stage and certainly before 6 wk of age.

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References

  1. Aronsson DD, Goldberg MJ, Kling TF Jr, Roy DR. Developmental dysplasia of the hip. Pediatrics. 1994;94:201–8.

    CAS  PubMed  Google Scholar 

  2. Marks DS, Clegg J, al-Chalabi AN. Routine ultrasound screening for neonatal hip instability. Can it abolish late-presenting congenital dislocation of the hip? J Bone Joint Surg (Br). 1994;76:534–8.

    CAS  Google Scholar 

  3. Leck I. Congenital dislocation of the hip. In: Wald N, Leck I, editors. Antenatal and neonatal screening. 2nd ed. Oxford: Oxford University Press; 2000. p. 398–424.

    Chapter  Google Scholar 

  4. Bialik V, Bialik GM, Blazer S, Sujov P, Wiener F, Berant M. Developmental dysplasia of the hip: a new approach to incidence. Pediatrics. 1999;103:93–9.

    CAS  Article  PubMed  Google Scholar 

  5. Atalar H, Sayli U, Yavuz OY, Uraş I, Dogruel H. Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip. Int Orthop. 2007;31:145–50.

    CAS  Article  PubMed  Google Scholar 

  6. Gardiner HM, Dunn PM. Controlled trial of immediate splinting versus ultrasonographic surveillance in congenitally dislocated hips. Lancet. 1990;336:1553–6.

    CAS  Article  PubMed  Google Scholar 

  7. Ortiz-Neira CL, Paolucci EO, Donnon T. A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol. 2012;81:e344–51.

    Article  PubMed  Google Scholar 

  8. Chan A, McCaul KA, Cundy PJ, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed. 1997;76:F94–100.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  9. Wynne-Davies R. Acetabular dysplasia and familial joint laxity: two aetiological factors in congenital dislocation of the hip. A review of 589 patients and their families. J Bone Joint Surg (Br). 1970;52:704–16.

    CAS  Google Scholar 

  10. Shi D, Dai J, Ikegawa S, Jiang Q. Genetic study on developmental dysplasia of the hip. Eur J Clin Investig. 2012;42:1121–5.

    CAS  Article  Google Scholar 

  11. Shipman SA, Helfand M, Moyer VA, Yawn BP. Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventative Services Task Force. Pediatrics. 2006;117:e557–76.

    Article  PubMed  Google Scholar 

  12. Chou DTS, Ramachandran M. Prevalence of developmental dysplasia of the hip in children with clubfoot. J Child Orthop. 2013;7:263–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. SMAC guidelines. Special report. Screening for the detection of congenital dislocation of the hip. Arch Dis Child. 1986;61:921–6.

    Article  Google Scholar 

  14. AAOS guidelines. Detection and non operative management of paediatric developmental dysplasia of the hip in infant upto 6 mo of age. Available at: www.aaos.org/research/guidelines/DDHGuidelineFINAL.pdf. Accessed on 5 Sep 2014.

  15. Ortolani M. Un segno poco noto e sua importanza per la diagnosi precoce di prelussazione conenita dell’anca. Pediatrica. 1937;45:129–36.

    Google Scholar 

  16. Barlow TG. Early diagnosis and treatment of congenital dislocation of the hip. J Bone Joint Surg (Br). 1962;44:292–301.

    Google Scholar 

  17. Myles JW. Secondary screening for congenital displacement of the hip. J Bone Joint Surg (Br). 1990;72:326–7.

    CAS  Google Scholar 

  18. Alsaleem M, Set KK, Saadeh L. Developmental dysplasia of hip: a review. Clin Pediatr (Phila). 2015;54:921–8.

    Article  Google Scholar 

  19. Holen KJ, Tegnander A, Bredland T, et al. Universal or selective screening of the neonatal hip using ultrasound? A prospective, randomised trial of 15,529 newborn infants. J Bone Joint Surg (Br). 2002;84:886–90.

    CAS  Article  Google Scholar 

  20. Ihme N, Altenhofen L, von Kries R, Niethard FU. Hip ultrasound screening in Germany. Results and comparison with other screening procedures. [Article in German]. Orthopade. 2008;37:541–6 .548-9

    CAS  Article  PubMed  Google Scholar 

  21. Woolacott NF, Puhan MA, Steurer J, Kleijnen J. Ultrasonography in screening for developmental dysplasia of the hip in newborns: systematic review. BMJ. 2005;330:1413.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Mubarak SJ, Bialik V. Pavlik: the man and his method. J Pediatr Orthop. 2003;23:342–6.

    PubMed  Google Scholar 

  23. Cooper AP, Doddabasappa SN, Mulpuri K. Evidence-based management of developmental dysplasia of the hip. Orthop Clin North Am. 2014;45:341–54.

    Article  PubMed  Google Scholar 

  24. Atar D, Lehman WB, Tetenbaum Y, Grant AD. Pavlik harness versus Frejka splint in treatment of developmental dysplasia of the hip: bicenter study. J Pediatr Orthop. 1993;13:311–3.

    CAS  Article  PubMed  Google Scholar 

  25. Heikkila E. Comparison of the Frejka pillow and the von Rosen splint in treatment of congenital dislocation of the hip. J Paediatr Orthop. 1988;8:20–1.

    CAS  Article  Google Scholar 

  26. Zionts LE, MacEwen GD. Treatment of congenital dislocation of the hip in children between the ages of one and 3 y. J Bone Joint Surg Am. 1986;68:829–46.

    CAS  Article  PubMed  Google Scholar 

  27. Malvitz TA, Weinstein SL. Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average age of 30 y. J Bone Joint Surg Am. 1994;76:1777–92.

    CAS  Article  PubMed  Google Scholar 

  28. Furnes O, Lie SA, Espehung B, Vollset SE, Engesaeter LB, Havelin LI. Hip disease and the prognosis of total hip replacements. A review of 53, 698 primary total hip replacements reported to the Norwegian arthroplasty register 1987-99. J Bone Joint Surg (Br). 2001;83:579–86.

    CAS  Article  Google Scholar 

  29. Shorter D, Hong T, Osborn DA. Cochrane review: screening programmes for developmental dysplasia of the hip in newborn infants. Evid Based Child Health. 2013;8:11–54.

    Article  PubMed  Google Scholar 

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Contributions

JT: Wrote the article; DO’D: Helped in writing and references; JAF: Edited, collected images, references and will act as guarantor for the paper.

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Correspondence to James Alfred Fernandes.

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Tomlinson, J., O’Dowd, D. & Fernandes, J.A. Managing Developmental Dysplasia of the Hip. Indian J Pediatr 83, 1275–1279 (2016). https://doi.org/10.1007/s12098-016-2160-9

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  • DOI: https://doi.org/10.1007/s12098-016-2160-9

Keywords

  • DDH
  • Dysplasia
  • Risk factors
  • Screening
  • Splinting
  • Surgery