Developmental dysplasia of the hip (DDH)

Developmental dysplasia of the hip (DDH) is common, ranging from mild dysplasia to frank dislocation. The diagnosis can be difficult, even in experienced hands, particularly when there are bilateral dislocations. All infants should be screened clinically, but the value of other screening methods, such as ultrasound is still debated. Initial treatment in the infant is with a Pavlik harness. If this is ineffective or if the child presents later, more aggressive treatment, such as a closed reduction, or even surgical reduction may be indicated. All hips must be carefully followed until maturity. If diagnosed and treated promptly excellent results can be obtained, but long-term sequelae occur even in patients given optimal treatment.