Hip Dysplasia in Newborns: Screening and Treatment

Developmental dysplasia of the hip (DDH) covers a broad spectrum of abnormal hip development, ranging from a simply immature hip to an unstable hip and frank dislocation. Newborn screening is designed precisely to identify, early on, the cases that need a dedicated pathway: in general, the earlier the diagnosis, the simpler and less invasive the treatment. The pathway is collaborative: it is based on the clinical examination of the newborn (dedicated maneuvers at birth) and on a hip ultrasound performed in the first months of life by a radiologist or specialist neonatal sonographer. The paediatric orthopaedic surgeon interprets the ultrasound together with the clinical findings and, when needed, sets up the treatment. Evaluation is particularly important in case of family history, breech presentation, oligohydramnios or evident asymmetries, but in many hospitals it is offered even without risk factors. Forms identified early respond in most cases to conservative treatment (e.g. Pavlik harness or other abduction devices). Forms diagnosed later or those frankly dislocated may require more structured pathways, up to reduction procedures and, in selected cases, joint remodeling surgery. The aim is not to create alarm — most screened newborns turn out to be normal — but to recognise, in time, the situations that deserve a dedicated paediatric orthopaedic pathway.