Developmental dysplasia of the hip

摘要

? Based on strong research evidence, the primary risk factors for developmental dysplasia of the hip (DDH) include female gender, family history, and breech presentation. (7)(15) ? Based on current standards of care and published guidelines, all children should receive routine clinical evaluation of their hips at each scheduled health supervision visit. (7)(11) ? Based primarily on consensus due to the lack of relevant clinical studies, children who have equivocal findings or increased risk factors for DDH (and normal examination findings) should undergo imaging with ultrasonography at age 3 to 4 weeks, or plain radiographs at 4 to 5 months if reliable ultrasonography is not available. (7)(8)(11) ? Based on strong research evidence, infants who manifest adventitial hip clicks do not require further imaging or referral to an orthopedic surgeon. (5)(7) ? Based on consensus due to the lack of relevant clinical studies, children who have unstable hips on clinical examination should be referred for treatment by an orthopedist. (7)(11) ? Based on consensus due to the lack of relevant clinical studies, children who have abnormal findings on radiographic evaluation, either on ultrasonography or plain radiographs, should be referred to an orthopedist for evaluation and determination of appropriate management. (7)(11).