Three-year prospective study of developmental dysplasia of the hip at birth: should all dislocated or dislocatable hips be treated?

This article presents a 3-year prospective study that includes 103 consecutive patients (137 hips) diagnosed with developmental dysplasia of the hip (DDH) at birth. Treatment was started after 2 weeks only if the hips had not stabilized spontaneously. Sonographic studies were first used when clinical stability was confirmed to ensure a true concentric hip reduction. The authors conclude that most patients with DDH at birth (73.8%) do not need treatment at that time, presenting with normal hips at the end of follow-up. When instability was still present after 2 weeks and a splint was applied (26.2%), there were no significant hip differences when compared with a control group of 50 patients (69 hips) who underwent treatment in the first days of life. With this approach, the authors could safely reduce the number of patients to be treated, the amount of sonographic studies, and consequently the final cost of the whole treatment.