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Developmental dysplasia of the hip
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of developmental dysplasia of the hip are prepared by our editorial team based on guidelines from the American Academy of Orthopaedic Surgeons (AAOS 2022), the Dutch Orthopaedic Society (DOS 2022), the American College of Radiology (ACR 2019), and the Pediatric Orthopaedic Society of North America (POSNA 2007).
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Screening and diagnosis
Diagnostic investigations
Hip ultrasound
As per AAOS 2022 guidelines:
Obtain imaging before 6 months of age in pediatric patients with ≥ 1 of the following risk factors:
breech presentation
family history
history of clinical instability
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Consider obtaining an ultrasound in pediatric patients < 6 weeks of age with a positive instability examination to guide the decision to initiate brace treatment.
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Pelvic radiography
Medical management
Nonpharmacologic interventions
Hip abduction braces: as per AAOS 2022 guidelines, consider offering either immediate or delayed (2-9 weeks) brace treatment for hips with a positive instability exam.
C
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Splinting
Closed reduction
Hip spica cast