Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.886
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
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.
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.