Developmental Dysplasia of the Hip (DDH)

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal disorders among newborns. It involves a spectrum of disease of the hip joint, ranging from mild dysplasia of the acetabulum to complete dislocation of the hip. It is important to diagnose and treat early, and there are several physical exam findings that can help diagnose the disorder in the newborn. Screening with ultrasound of the hip is useful in newborns with certain risk factors including breech presentation, firstborn child, family history of DDH, or clinical instability. Treatment depends on several factors, but the most common initial management is the use of a Pavlik harness in newborns. This harness keeps the hip in a position that allows hip stabilization and encourages appropriate joint development. Early treatment is crucial in the development of the hip joint. Treatments other than Pavlik harness include static bracing, operative closed reduction and ting, open reduction and ting, and acetabular or femoral osteotomies. Failure to identify or treat may result in hip dysfunction and early arthritis.