This narrative review covers the diagnosis and management of developmental dysplasia of the hip (DDH) in infants from birth to six months, addressing the full spectrum from mild dysplasia through frank dislocation. It synthesizes epidemiology, pathologic anatomy, clinical examination techniques, imaging modalities, and treatment algorithms for the period when non-operative management is most likely to succeed.
When you pick up an unstable hip in a newborn, start the Pavlik harness immediately for frank dislocation (no observation period needed) or after 3 weeks if subluxation persists — but perform weekly checks and cut to closed reduction under anesthesia if you don't have stable reduction by 2 weeks, because prolonged failed harness treatment worsens subsequent outcomes.
Don't let a normal 3- or 5-year radiograph close the case: counsel families that late acetabular dysplasia emerges in roughly 1 in 6 successfully treated hips and requires follow-up to skeletal maturity.
This narrative review covers the diagnosis and management of developmental dysplasia of the hip (DDH) in infants from birth to six months, addressing the full spectrum from mild dysplasia through frank dislocation. It synthesizes epidemiology, pathologic anatomy, clinical examination techniques, imaging modalities, and treatment algorithms for the period when non-operative management is most likely to succeed.
When you pick up an unstable hip in a newborn, start the Pavlik harness immediately for frank dislocation (no observation period needed) or after 3 weeks if subluxation persists — but perform weekly checks and cut to closed reduction under anesthesia if you don't have stable reduction by 2 weeks, because prolonged failed harness treatment worsens subsequent outcomes.
Don't let a normal 3- or 5-year radiograph close the case: counsel families that late acetabular dysplasia emerges in roughly 1 in 6 successfully treated hips and requires follow-up to skeletal maturity.