Child Orthopedics

Frequently Asked Questions

Our baby might have a hip problem but we're not sure. His pediatrician said the test was positive for developmental hip dysplasia. But the orthopedic surgeon we went to said the test was negative. Who do we believe? What do we do now?

Screening of newborns for possible hip deformities can help prevent long-term problems. But when test results are positive or mixed, it can cause great concern on the part of the parents and other family members.

The main condition doctors are looking for is called developmental dysplasia of the hip (DDH). A shallow depression called dysplasia in the acetabulum (hip socket) can lead to hip dislocation. In many cases, identifying this problem early can prevent serious problems later.

There are several tests the doctor can perform to find DDH. None of these tests are foolproof. Sometimes there are false-positive results. A false positive means that a test claims something is positive when that's not the case. In fact, when using the most reliable test for DDH (Ortolani's maneuver) there are false-positive findings about 25 per cent of the time.

That's why a second opinion and further testing is a good idea. When results are in question, parents are instructed in proper ways to manage the problem. The testing is repeated at regular intervals. Imaging studies such as ultrasound to see the shape and position of the hip can also aid in the diagnosis.

For children less than six months old, double diapering and carrying the child with his or her legs around the parents' waist may be advised. In some cases, a special device called the Pavlik harness is used to hold the hips in proper alignment.

If your physician has not talked to you about these preventive steps, don't hesitate to make a follow-up appointment to discuss options. With the proper screening and prevention techniques, most children develop normal hips and do not need further treatment.

Jeffrey E. Martus, and Daniel J. Sucato, MD. Developmental Disorders of the Hip Age 0-8 Years. In Current Opinion in Orthopaedics. November 2007. Vol. 18. No. 6. Pp. 529-535.

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