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

Patient Guideline Summary

Publication Date: March 20, 2022
Last Updated: November 2, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the American Academy of Orthopaedic Surgeons (AAOS) for Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age.

Overview

Overview

  • Hip dysplasia describes an incomplete formation of the hip joint during fetal development. Signs include a short leg, a stiff joint, or a limp.
  • This patient summary focuses on diagnosis and non-surgical management.

Diagnosis

Diagnosis

  • Routine ultrasound imaging of newborns is not recommended.
  • If a risk factor is present — breech presentation, family history, or history of clinical instability — AAOS recommends imaging before 6 months of age.
  • AAOS suggests ultrasound imaging if hip instability is found on a physical examination of an infant under 6 months of age.
  • AAOS prefers a hip x-ray rather than an ultrasound after 4 months of age.
  • Infants should have more than one hip examination before 6 months of age.

Treatment

Treatment

  • If exams are normal but an ultrasound is abnormal, AAOS recommends repeat examinations without bracing.
  • If an exam demonstrates instability, brace treatment should begin within 9 weeks.
  • AAOS prefers a van Rosen splint over others for initial treatment.
  • During treatment, patients should be examined and imaged periodically.

Abbreviations

  • AAOS: American Academy Of Orthopedic Surgeons

Source Citation

American Academy of Orthopaedic Surgeons EvidenceBased Clinical Practice Guideline for the Detection and Nonoperative Management of Pediatric Dysplasia of the Hip in Infants Up to Six Months of Age. https://www.aaos.org/aaos.org/pddhcpg Published March 21, 2022

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.