Developmental Hip Dysplasia: What Has Changed in the Last 30 Years?

Abstract

Developmental dysplasia of the hip (DDH) is a common and important topic in paediatric orthopaedics. Early diagnosis and treatment are critical. Screening for this condition is important. In 1992 year we introduced ultrasound hip screening for all newborns at 4 – 6 weeks of age. Treatment depends on the age of the child and the reducibility of the hip joint. At an early age and up to 6 months the main treatment is an abduction brace like the Pavlik harness. If this fails, gradual reduction using long-term traction and next closed reduction and spica casting have been done. After the age of 18 month, treatment usually consists of open reduction and hip reconstruction surgery by the Dega method. As compared to the period before the introduction of universal ultrasound, there is now about a 10-fold decrease in severe surgery of dislocated hips. The universal ultrasound screening programme has caused a reduction in the number of surgical interventions.