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
American Academy of Orthopaedic Surgeons
Endorsing Organizations
American Academy of Pediatrics
Pediatric Orthopaedic Society
Publication Month/Year
September 5, 2014
Last Updated Month/Year
February 12, 2024
Supplemental Implementation Tools
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