Represents a spectrum of conditions affecting the proximal femur and acetabulum, ranging from acetabular immaturity to hip subluxation and frank hip dislocation.
The Barlow and Ortolani screening tests are recommended up to 6 months of age. Thereafter, limited and/or asymmetric hip abduction suggests the diagnosis.
Ultrasound may be used to confirm an abnormal hip exam, but should be used with caution as a preliminary screening test due to the high number of false positive results.
There is a high rate of spontaneous resolution of hips identified as abnormal by both clinical exam and ultrasound in the neonatal period. Frank dislocations and persistently abnormal exams should be referred to a pediatric orthopedist.
Most cases can be treated nonsurgically using an abduction harness (Pavlik harness).
Surgery is required for children with severe DDH or those who have failed treatment with an abduction harness, and in older children.
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