DEVELOPMENTAL DYSPLASIA OF THE HIP

Key words: Developmental dysplasia of the hip, Screening

Developmental dysplasia of the hip (DDH) describes a wide range of hip abnormalities, from a shallow acetabulum to a dislocated hip. The abnormality can be present at birth but also occur at later stages. Without therapy, patients with completely dislocated hips develop gait disturbance and those with subluxation develop degenerative joint disease. Early diagnosis and treatment of DDH ensure the best chances of achieving successful results. Clinical and ultrasound examination (but not X rays) are helpful for early diagnosis of DDH. Treatment is required for patients with clinical dislocated or dislocating hips and for those with hip ultrasound abnormalities type C, D, 3 and 4, according to Graf criteria. Therapy of DDH consists of three steps: reduction, immobilization and anatomic recovery. Abduction devices as pillows, Milgram and Pavlik harness and casts are used for DDH therapy. Late diagnoses are reduced by DDH screening. When late diagnoses are more than 0.4% of newborns and patients require hospitalization for treatment, general ultrasound screening can be cost-effective.