From early diagnosis to reducing the sequelae of hip dysplasia in development. Developmental dysplasia of the hip
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Abstract
Objectives: To differentiate the presentations of developing hip dysplasia (DCD); propose a universal screening for diagnosis and timely treatment that reduce sequelae. Methods: This is a narrative review with systematic review tools. The search was done in MEDLINE (including PUBMED), Embase, Ovid, Proquest, COCHRANE, LILACS, the Virtual Health Library VHL, Redalyc, and academic Google. No publication time limit; this search was conducted between January and June 2022 and included clinical practice guidelines, systematic reviews, meta-analyses, and topic reviews that evaluated the epidemiology, etiology, pathophysiology, diagnosis, and treatment of DCD. Duplicate references were discarded. Quality was assessed by the Delphi method, based on the consultants' experience (Doctors Rodriguez-Alvira and Rosselli-Cock), to unify the timely diagnosis of DCD in Colombia by general practitioners, pediatricians, orthopedists, and pediatric orthopedists. Results: Diagnosis of DCD is recommended before four months with dynamic hip ultrasound and between 4 to 6 months of age with hip radiography. If ultrasound is unavailable, radiography should be used and evaluated by the doctor from the clinic to imaging with timely referral to children's orthopedics to initiate treatment and follow-up. Conclusions: Early detection of DCD reduces the need for invasive surgical procedures due to the potential to remodel the acetabulum in the first year of life. Failure to diagnose DCD promptly increases morbidity and mortality and the burden of the disease in the short term and adult life.
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