Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age

Publication Date: September 5, 2014
Last Updated: March 14, 2022

RECOMMENDATIONS

UNIVERSAL ULTRASOUND SCREENING

Moderate evidence supports not performing universal ultrasound screening of newborn infants. (M)
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EVALUATION OF INFANTS WITH RISK FACTORS FOR DDH

Moderate evidence supports performing an imaging study before 6 months of age in infants with one or more of the following risk factors: breech presentation, family history, or history of clinical instability. (M)
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IMAGING OF THE UNSTABLE HIP

Limited evidence supports that the practitioner might obtain an ultrasound in infants less than 6 weeks of age with a positive instability examination to guide the decision to initiate brace treatment. (L)
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IMAGING OF THE INFANT HIP

Limited evidence supports the use of an AP pelvis radiograph instead of an ultrasound to assess DDH in infants beginning at 4 months of age. (L)
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SURVEILLANCE AFTER NORMAL INFANT HIP EXAM

Limited evidence supports that a practitioner re-examine infants previously screened as having a normal hip examination on subsequent visits prior to 6 months of age. (L)
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STABLE HIP WITH ULTRASOUND IMAGING ABNORMALITIES

Limited evidence supports observation without a brace for infants with a clinically stable hip with morphologic ultrasound imaging abnormalities. (L)
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TREATMENT OF CLINICAL INSTABILITY

Limited evidence supports either immediate or delayed (2-9 weeks) brace treatment for hips with a positive instability exam. (L)
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TYPE OF BRACE FOR THE UNSTABLE HIP

Limited evidence supports use of the von Rosen splint over Pavlik, Craig, or Frejka splints for initial treatment of an unstable hip. (L)
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MONITORING OF PATIENTS DURING BRACE TREATMENT

Limited evidence supports that the practitioner perform serial physical examinations and periodic imaging assessments (ultrasound or radiograph based on age) during management for unstable infant hips. (L)
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Recommendation Grading

Overview

Title

Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age

Authoring Organization

Endorsing Organizations

Publication Month/Year

September 5, 2014

Last Updated Month/Year

February 12, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Target Patient Population

Infants with hip dysplasia

Target Provider Population

Orthopedic surgeons; pediatricians; radiology

Inclusion Criteria

Female, Male, Infant

Health Care Settings

Ambulatory, Hospital, Radiology services

Intended Users

Radiology technologist, nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Diagnosis, Treatment

Keywords

dysplasia, hip dysplasia, pediatric dyplasia, infant dysplasia

Supplemental Methodology Resources

Data Supplement, Data Supplement