Newborn Care Guidelines for Developmental Dislocation of the Hip

Developmental dysplasia of the hip (DDH) describes a spectrum of conditions related to the development of the hip in infants and young children. It encompasses abnormal development of the acetabulum and proximal femur and mechanical instability of the hip joint. Newborns often have physiologic laxity of the hip and immaturity of the acetabulum during the first few weeks of life. In most cases, the laxity resolves, and the acetabulum proceeds to develop normally. With assessment of risk factors, serial physical examination of the hips, and appropriate use of imaging studies, most children with pathologic hips can be correctly diagnosed and treated without long-term sequelae. Clinical screening of all neonatal hips is currently accepted as the most economic assessment of hips in many countries, with infants considered at risk of DDH or with hips demonstrating subluxation then undergoing Graf ultrasound examination at 6 weeks of age.