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Abstract
DDH is a spectrum of hip joint development disorders present in different forms and presenting at different ages. The main issue is abnormal relation of femoral head to acetabulum.
Diagnosis is done by clinical examination using Barlow’s and Ortolani’s test and ultrasonographic examination using dynamic and static technique. Other clinical signs limb length discrepancy limited abduction and asymmetrical skin crease. The incidence of DDH world wide is 1-2 for every 1000 neonates. It depends on ethnic and geographic and cultural factors.
Risk factors of DDH include: female positive family history, first pregnancy, breech presentation oligohydramnious, multiple pregnancy, neuromuscular disorder as spina bifida and other associated anomalies as club foot.
DDH includes two types: a typical type occurring in the perinatal period in neurologically free patients and a teratological one which occurs in utero with those who have neuromuscular disorders.
Early diagnosis and treatment is important because late detection can results in significant morbidity. Treatment in early detected cases is usually done by abduction splints (Pavlik Harness) and lately diagnosed cases are mainly treated surgically.
Costs of implementing a screening program for DDH is not compared to the costs of treatment of lately diagnosed cases.