July/August 2016
13
feature
advanced arthritis, hip replacement is the treatment of choice. This
course is more typical for patients in their fourth decade and beyond.
Summary
The diagnosis of DDH represents a spectrum of disorders that is
common (i.e., noted in about 1 of 100 newborns). Early recognition
of DDH is critical. In infancy, DDH is an asymptomatic condition
that can be easily overlooked. All providers taking care of newborn
children should know how to recognize DDH and when to refer
these children for appropriate treatment. All newborns should be
screened for DDH by physical examination. Performing a careful
physical examination, being aware of DDH risk factors, and
obtaining appropriate and timely imaging are needed for this
diagnosis. Once the diagnosis is made, treatment for DDH is
usually straightforward and generally successful.
About the Author
Dr. Klane White
is a Pediatric Orthopedic Surgeon at Seattle Children’s
Hospital and associate professor in the Department of Orthopaedics and Sport
Medicine, University of Washington School of Medicine.
BIBLIOGRAPHY
Cooperman DR, Wallensten R, Stulberg SD, “Acetabular dysplasia in the
adult.”
Clin Orthop Relat Res
, 1983; 175:79–85.
Wedge JH, Wasylenko MJ, “The natural history of congenital disease of the
hip.”
J Bone Joint Surg Br
, 1979; 61:334–338.
Ortolani M, “Un segno poco noto e sua importanza per la diagnosi precoce
di prelussazione congenita dell’anca.”
Paediatria (Napoli)
, 1937; 45:129.
Barlow TG, “Early diagnosis and treatment of congenital dislocation of the
hip.”
J Bone Joint Surg Br
, 1962; 44:292–301.
Terjesen T, Bredland T, Berg V, “Ultrasound for hip assessment in the
newborn.”
J Bone Joint Surg Br
, 1989; 71:767–773.
Clarke NM, Harcke HT, McHugh P, et al, “Real-time ultrasound in the
diagnosis of congenital dislocation and dysplasia of the hip.”
J Bone Joint
Surg Br
, 1985; 67:406–412.
Graf R, “Fundamentals of sonographic diagnosis of infant hip dysplasia.”
J
Pediatr Orthop
, 1984; 4:735–740.
Mulpuri K, Song KM, Gross RH, et al, “The American Academy of
Orthopaedic Surgeons Evidence-Based Guideline on Detection and
Nonoperative Management of Pediatric Developmental Dysplasia of the Hip
in Infants up to Six Months of Age.”
J Bone Joint Surg Am
, 2015; 97:1717–8.
Viere RG, Birch JG, Herring JA, Roach JW, and CE Johnston, “Use of the
Pavlik harness in congenital dislocation of the hip. An analysis of failures of
treatment.”
J Bone Joint Surg Am
, 1990; 72:238–244
