Narrative review covering diagnosis and treatment of DDH first identified between ages 6 months and 4 years — the window when Pavlik harness therapy is no longer reliable and pathoanatomic complexity demands individualized surgical decision-making across bracing, closed reduction, open reduction, and femoral or pelvic osteotomy.
When a child aged 6 months to 4 years presents with DDH, anchor your decision-making to pathoanatomy and remodeling potential rather than age alone: use intraoperative arthrography to confirm a dye pool under 7 mm, cap spica abduction at 55 degrees, and add femoral shortening whenever reduction feels tense to drive osteonecrosis risk toward zero.
Narrative review covering diagnosis and treatment of DDH first identified between ages 6 months and 4 years — the window when Pavlik harness therapy is no longer reliable and pathoanatomic complexity demands individualized surgical decision-making across bracing, closed reduction, open reduction, and femoral or pelvic osteotomy.
When a child aged 6 months to 4 years presents with DDH, anchor your decision-making to pathoanatomy and remodeling potential rather than age alone: use intraoperative arthrography to confirm a dye pool under 7 mm, cap spica abduction at 55 degrees, and add femoral shortening whenever reduction feels tense to drive osteonecrosis risk toward zero.