Developmental disorders of the hip age 0-8 years

PURPOSE OF REVIEW: To review the recent literature and emphasize research that impacts the clinical management of developmental dysplasia of the hip. RECENT FINDINGS: Recent literature relevant to screening for developmental dysplasia of the hip was reviewed. The Ortolani examination maneuver was correlated with the sonographic position of the femoral head; a 25% false positive rate was noted. A report of late dislocations associated with an early stable clinical examination and minor sonographic abnormalities emphasizes the need for evidence-based guidelines on the management of isolated sonographic dysplasia. The mechanical properties of the ligamentum teres are similar to the anterior cruciate ligament; this structure should perhaps be preserved during open hip reduction. The timing and upper age limit of reduction of a developmental hip dislocation continues to be controversial. Contrary to prior assumptions, Dega osteotomy increases acetabular volume. There is an association between developmental dysplasia of the hip, acetabular retroversion, and osteoarthritis. SUMMARY: The articles reviewed were selected for relevance to clinical management of developmental dysplasia of the hip. Specific areas reviewed include screening, management of the normal clinical exam with sonographic abnormality, reliability of common physical exam findings, timing and upper age limit for reduction of developmental hip dislocation, mechanical properties of the ligamentum teres, volumetric change following acetabuloplasty, and the association between developmental dysplasia of the hip, acetabular retroversion, and osteoarthritis.