Management of Developmental Dysplasia of the Hip

Developmental dysplasia of the hip (DDH) encompasses a spectrum of hip‐joint abnormalities in infants, ranging from mild ligamentous laxity to complete femoral head dislocation. Early identification through clinical examination and imaging is central to successful management. Newborn screening strategies balance universal sonographic assessment against selective imaging of high-risk groups, with protocols varying according to regional prevalence and resource availability. When instability is detected, non-operative treatment with dynamic bracing—commonly a Pavlik harness—promotes concentric reduction and acetabular development. Close monitoring through serial ultrasonography or radiography guides adjustments in positioning and duration of treatment. In cases of late presentation or failure of conservative measures, closed or open reduction followed by spica casting, and, in older infants, pelvic or femoral osteotomies may be required. Multidisciplinary care, including physiotherapy and genetic counselling, supports functional outcomes and addresses associated risk factors. Long-term follow-up is essential to detect residual dysplasia and avert early osteoarthritis, emphasising the global imperative for standardised, resource-sensitive management pathways.

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Management of Developmental Dysplasia of the Hip publication trend

The graph below shows the total number of articles in management of developmental dysplasia of the hip across all publications each year (not limited to Nature Index journals).

Technical terms

Developmental Dysplasia of the Hip (DDH): Spectrum of hip joint malformations in infants, from mild instability to complete dislocation.

Ultrasonography: Imaging modality using high-frequency sound waves to visualise neonatal hip morphology and detect dysplasia.

Pavlik harness: A dynamic brace positioning the hips in flexion and abduction to stabilise and promote reduction of the femoral head within the acetabulum.

Sulphate metabolomics: Analytical study of sulphate and related anions in biological fluids to identify metabolic alterations associated with DDH.

Deep-learning neural network: An artificial intelligence model trained on imaging data to recognise anatomical landmarks and standardise ultrasonographic planes.

References

1. An Explorative Study into the Aetiology of Developmental Dysplasia of the Hip Using Targeted Urine Metabolomics. Antioxidants (2023).
2. Deep learning-based automated guide for defining a standard imaging plane for developmental dysplasia of the hip screening using ultrasonography: a retrospective imaging analysis. BMC Medical Informatics and Decision Making (2025).
3. Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip: The Austrian hip screening program. Journal of Children's Orthopaedics (2014).