Diagnosis and management of developmental hip dysplasia

Abstract

Congenital dislocation of the hip represents a spectrum of disease from transient neonatal hip instability to established dislocation. Known risk factors include breech presentation and a positive family history. Emphasis should be placed on early diagnosis and treatment to minimise the need for surgical intervention. Clinical assessment has limited accuracy which further diminishes soon after birth. Ultrasound based screening is more sensitive, but controversy remains as to which method to use and its effect on outcome. When initiated early, treatment using a simple abduction device such as a Pavlik harness has an excellent success rate. Resistant cases and late presentations usually require surgical management, which are largely age dependent. We discuss the condition, detail the screening protocol in our institution and outline the surgical options in this article.