Abstract
Developmental Dysplasia of the Hip (DDH) describes a wide range of anatomic abnormalities of the growing hips which might result in permanent abnormal gait. Therefore, early detection and management is crucial to improve the outcome and minimise the risk of osteoarthritis in later life. Hip ultrasound is used to evaluate DDH based on Graf classification. Graf score is a widely used ultrasound grading score to evaluate DDH in infants. There is conflicting evidence regarding the management of the developmentally immature Graf type IIa hip. Some physicians adopt watchful waiting for natural maturation of hips while other early treatment. This article will provide an evidence-based review on the management modalities of the Graf type IIa hip.
Highlights
Developmental Dysplasia of the Hip (DDH) is a common musculoskeletal problem affecting newborn infants
Developmental Dysplasia of the Hip (DDH) describes a wide range of anatomic abnormalities of the growing hips which might result in permanent abnormal gait
Hips ultrasound is the investigation of choice within the first 3 months of age, and it is highly recommended for infants with risk factors for DDH or abnormal clinical examinations of the hips [9]
Summary
Developmental Dysplasia of the Hip (DDH) is a common musculoskeletal problem affecting newborn infants. Ortolani and Barlow tests are most common screening tests which are commonly performed as a part of clinical examination of newborn infants [6] These two tests are not useful in infants older than 6 - 8 weeks as muscle strength increases, and capsule laxity reduces [7]. Hips ultrasound is the investigation of choice within the first 3 months of age, and it is highly recommended for infants with risk factors for DDH or abnormal clinical examinations of the hips [9]. According to the American Academy of Pediatrics (AAP) guidelines, hip ultrasound and radiograph are effective imaging modalities for detecting DDH in infants with age of 4 - 6 months [8]. By 4 months of age, hip radiographs become more reliable, when the ossification centre develops in the femoral head [8]
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