Evolution of Conservative Treatment Methods for Developmental Dysplasia of the Hip: A Review

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

One of the key conditions for preventing dysplastic coxarthrosis among infants and young children is the timely and effective treatment of developmental dysplasia of the hip. Despite numerous studies on this subject, the incidence of severe complications remains high, leading to dysplastic coxarthrosis in 40%–86.3% of patients and to disability in 11%–38%, indicating the social significance of the problem. This study reviewed international scientific data on the conservative treatment of developmental dysplasia of the hip in infants and young children available in open-access databases (i.e., PubMed, Science Direct, Google Scholar, and eLibrary) covering the period from 1830 to 2025. Over the years, conservative treatment of developmental dysplasia of the hip has remained a pressing issue in pediatric orthopedics. At present, the functional method is recognized as the optimal treatment approach for developmental dysplasia of the hip in infants and young children. It involves gradual centering of the femoral head within the acetabulum and immobilization of the lower limbs while preserving joint mobility. In the past decade, numerous studies have been published on this subject. Furthermore, many studies have proposed refinements to the functional method and have developed and implemented new splint designs that maintain motor activity in the hip joints while avoiding excessive abduction of the femurs (>60°), thereby improving treatment quality and effectiveness. The evolution of conservative treatment methods for developmental dysplasia of the hip demonstrates fundamental principles of pediatric orthopedics that remain relevant today: early detection of condition, immediate initiation of functional treatment upon diagnosis, timely transition to surgical treatment in the absence of positive changes, timely identification of teratogenic dislocations requiring primary surgical correction, long-term follow-up until skeletal maturity, and rehabilitation to prevent early dysplastic coxarthrosis when indicated.

Full Text

Restricted Access

About the authors

Alyona V. Grigorieva

Saratov State Medical University named after V.I. Razumovsky

Author for correspondence.
Email: alena-grig00@mail.ru
ORCID iD: 0009-0001-8031-0193
SPIN-code: 9826-0378

MD, Cand. Sci. (Medicine)

Russian Federation, Saratov

Igor A. Norkin

Saratov State Medical University named after V.I. Razumovsky

Email: norkinia@sarniito.ru
ORCID iD: 0000-0002-6770-3398
SPIN-code: 9253-7993

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saratov

References

  1. Bakarman K, Alsiddiky AM, Zamzam M, et al. Developmental dysplasia of the hip (DDH): etiology, diagnosis, and management. Cureus. 2023;15(8):e43207. doi: 10.7759/cureus.43207 EDN: HGHOZS
  2. Tikhilov RM, Lila AM, Kochish AY, et al. Coxarthrosis. Clinic, diagnosis and treatment: clinical guidelines (abridged version). N.N. Priorov J Traumatology and Orthopedics. 2022;29(1):87–112. doi: 10.17816/vto107102 EDN: KKEXYI
  3. Baskov VE, Vissarionov SV, Filippova MS, et al. Current issues in the diagnostics of hip dysplasia in newborns in the regions of the Russian Federation. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2023;11(4):439–448. doi: 10.17816/PTORS603050 EDN: LTSMXU
  4. Nandhagopal T, Tiwari V, De Cicco FL. Developmental dysplasia of the hip 2024. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
  5. Tastanbekova ZU, Lozovoy VM, Karabekova RA, Trofimchuk VA. Diagnosis and treatment of developmental hip dysplasia in children. Med J Astana. 2020;3(105):169–172.
  6. Alhaddad A, Gronfula AG, Alsharif TH, et al. An overview of developmental dysplasia of the hip and its management timing and approaches. Cureus. 2023;15(9):e45503. doi: 10.7759/cureus.45503 EDN: VSWNJC
  7. Mirzoeva SM, Kurbanov SK, Kurbanova RT, et al. Early diagnosis and treatment of congenital hip joint pathology in children. Bull Acad Med Sci Tajikistan. 2017;7(4):42–46. EDN: YVNHYX
  8. International Classification of Diseases, 10th revision (ICD-10). Available from: https://mkb-10.com/. Accessed: 23.06.2025.
  9. Pakhomova NY, Strokova EL, Kozhevnikov VV, et al. Congenital dislocation of the hip – theories, etiological and predisposing factors (risk factors). The Siberian Scientific Medical Journal. 2022;42(4):62–73. doi: 10.18699/SSMJ20220405 EDN: HAMLVU
  10. Turdaliyeva BS, Aimbetova GE, Krestyashin VM, et al. Prognostic signs for the development of hip dysplasia in children. Life and Health Science. 2020;(1):58–63. doi: 10.24411/1995-5871-2020-10066 EDN: REOROS
  11. Ulziibat M, Munkhuu B, Bataa AE, et al. Traditional Mongolian swaddling and developmental dysplasia of the hip: a randomized controlled trial. BMC Pediatr. 2021;21(1):450. doi: 10.1186/s12887-021-02910-x EDN: WZRUKE
  12. Vaidya S, Aroojis A, Mehta R. Developmental dysplasia of hip and post-natal positioning: role of swaddling and baby-wearing. Indian J Orthop. 2021;55(6):1410–1416. doi: 10.1007/s43465-021-00513-3 EDN: OPTZEA
  13. Ömeroğlu H, Akceylan A, Köse N. Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study. J Child Orthop. 2019;13(2):161–166. doi: 10.1302/1863-2548.13.180174
  14. Husum HC, Thomsen JL, Kold S, et al. Referral criteria recognition of screeners in the Danish screening programme for hip dysplasia. Dan Med J. 2022;69(2):A01210098.
  15. Bohaček I, Plečko M, Duvančić T, et al. Current knowledge on the genetic background of developmental dysplasia of the hip and the histomorphological status of the cartilage. Croat Med J. 2020;61(3):260–270. doi: 10.3325/cmj.2020.61.260 EDN: YSAJOH
  16. Kamosko MM, Poznovich MS. Conservative treatment of hip dysplasia. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(4):51–60. doi: 10.17816/PTORS2451-60 EDN: TGIWAJ
  17. Pozdnikin IY, Baskov VE, Voloshin SY, et al. Errors of diagnosis and the initiation of conservative treatment in children with congenital hip dislocation. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2017;5(2):42–51. doi: 10.17816/PTORS5242-51 EDN: YSTYJF
  18. Levytskyy AF, Golovatiuk DV, Karabeniuk OV, et al. Diagnostics and treatment of hip dysplasia and congenital hip dislocation in children. Pediatric Surgery. 2019;1(62):90–98. doi: 10.15574/PS.2019.62.90 EDN: MQECKQ
  19. Chavoshi M, Soltani G, Shafiei Zargar S, et al. Diagnostic performance of clinical examination versus ultrasonography in the detection of developmental dysplasia of hip: a systematic review and meta-analysis. Arch Bone Jt Surg. 2022;10(5):403–412. doi: 10.22038/ABJS.2021
  20. Safronova DP, Khalezova GV, Yudina EV. Modern technologies in the diagnosis of hip joints in newborns and young children. New Sci Theor Pract View. 2017;1(3):13–16. EDN: XXWVTL
  21. Han J, Li Y. Progress in screening strategies for neonatal developmental dysplasia of the hip. Front Surg. 2022;9:995949. doi: 10.3389/fsurg.2022.995949 EDN: MPEKMP
  22. Graf R. Hip Sonography. Berlin, Heidelberg: Springer; 1999. 114 p. doi: 10.1007/3-540-30958-6
  23. Walter SG, Ossendorff R, Yagdiran A, et al. Four decades of developmental dysplastic hip screening according to Graf: What have we learned? Front Pediatr. 2022;10:990806. doi: 10.3389/fped.2022.990806 EDN: CBJTCX
  24. Doski J, Mosa L, Hassawi Q. An upgrade of the International Hip Dysplasia Institute classification for developmental dysplasia of the hip. Clin Orthop Surg. 2022;14(1):141–147. doi: 10.4055/cios21075
  25. Humbert M. Congenital dislocation of the femur. Etiology and treatment. Bull Acad Med. 1838;(6):39. (In French.)
  26. Pravaz CG. Congenital dislocation of the femur. Bull Acad Med (Paris). 1837;(579):2. (In French.)
  27. Dupuytren G. Memory on an original or congenital displacement of the head of the femurs. Répertoire Gén Anat Physiol Pathol. 1826;(2):82–93. (In French.)
  28. Poggi A. Contributo to the cure of the birth of the congenital lussazione dell’anca. Arch Ortop (Milano). 1888;(4):105. (In Italian.)
  29. Margary F. Operative treatment of hip dislocation. Arch Ortop (Milano). 1884;(2):38. (In Italian.)
  30. Paci A. New contribution to the pathology of iliac dislocation of the femur. Arch Atti Soc Ital Chir. 1887;(3):444. (In Italian.)
  31. Lorenz A. On the mechanical treatment of congenital hip dislocation. Zentralbl Chir. 1895;(22):153. (In German.)
  32. Bade P. The congenital hip dislocation. Ferdinand Enke Verlag; 1907. 303 p. (In German.)
  33. Joachimstanl G. The retention of the dislocated femoral head through the reformation of the bony acetabular roof. Verh Dtsch Orthop Ges. 1909;(8):152. (In German.)
  34. Lange F. Textbook of orthopedics. Gustav Fischer Verlag; 1928. 718 p. (In German.)
  35. Calot F. Essential Orthopedics. A. Maloine; 1911. 1032 p. (In French.)
  36. Hilgenreiner H. For early diagnosis and early treatment of congenital hip dislocation. Med Klin. 1925;(21):1385–1388. (In German.)
  37. Roser W. About congenital hip dislocation. Arch Chir. 1879;(24):309–313. (In German.)
  38. Dzhamalbekova ED, Dzhumabekov S. Results of early diagnostics and treatment of hip dysplasia in children in infancy. Bull Sci Pract. 2019;5(9):68–72. doi: 10.33619/2414-2948/46/06 EDN: QFKOAZ
  39. Schede M. Congenital dislocation of the hip. Lucas Gräfe & Sillem; 1900. 26 p. (In German.)
  40. Marletta DA, Zampogna B, Giuca G, et al. Impact of age and timing of hip orthosis on treatment outcomes in infants with developmental dysplasia of the hip: A systematic review and meta-analysis. J Clin Orthop Trauma. 2025;64:102944. doi: 10.1016/j.jcot.2025.102944 EDN: XFDORE
  41. Zhang G, Li M, Qu X, et al. Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis. J Orthop Surg Res. 2020;15(1):579. doi: 10.1186/s13018-020-02098-3 EDN: EXMUFK
  42. Forrester-Brown M. Device for the treatment of cong. dislocation. In newborns. Chir Organi Mov. 1933;(18):119. (In Italian.)
  43. Bauer F. The new treatment of congenital hip dislocation with the spreader band. Med Klin. 1935;(31):110. (In German.)
  44. Frejka B. Prevention of congenital hip joint dislocation using the abduction pad. Wiener Med Wochenschr. 1941;(25):523–524. (In German.)
  45. Pavlic A. A harness for treatment of congenital hip dislocation in infants. Acta Chir Orthop Traumatol Cech. 1953;20(5-6):93–100. (In Czech.)
  46. Bin K, Laville JM, Salmeron F. Developmental dysplasia of the hip in neonates: evolution of acetabular dysplasia after hip stabilization by brief Pavlik harness treatment. Orthop Traumatol Surg Res. 2014;100(4):357–361. doi: 10.1016/j.otsr.2014.03.017
  47. Semenov AL, Kharitonov KN. Tactics of management of children of the first months of life with hip dysplasia in subluxation and dislocation stages in the outpatient practice of the Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Pediatriya. Zhurnal im G.N. Speranskogo. 2019;98(2):248–252. doi: 10.24110/0031-403X-2019-98-2-248-252 EDN: ZAOCEH
  48. Zatsepin TS. Orthopedics of childhood and adolescence. Moscow: Medgiz; 1949. 276 p. (In Russ.)
  49. Somerville EW, Scott JC. The direct approach to congenital dislocation of the hip. J Bone Joint Surg Br. 1957;39-B(4):623. doi: 10.1302/0301-620X.39B4.623
  50. Craig WA, Risser JC, Kramer WG. Review of four hundred cases of congenital dysplasia and dislocation of the hip. J Bone Joint Surg Am. 1955;37:403–404.
  51. Klisic P, Rakic D, Pajic D. Triple prevention of congenital dislocation of the hip. J Pediatr Orthop. 1984;4(6):759–761. doi: 10.1097/01241398-198411000-00022
  52. Dzhamalbekova ED. Early diagnosis and treatment of hip dysplasia in children in infancy. Bull Sci Pract. 2019;5(9):59–67. doi: 10.33619/2414-2948/46/05 EDN: IYAWXZ
  53. Voloshin SY, Belousova EA. Features rehabilitation of infants with congenital hip dislocation on the stages of conservative treatment. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):66–70. doi: 10.17816/PTORS3266-70 EDN: UDSGBL
  54. Patent RUS No. 2762498/21.12.2021. Bull. No. 36. Voloshin SY, Vissarionov SV, Kartavenko KA, et al. Splint for the treatment of hip dysplasia in young children. Available from: https://yandex.ru/patents/doc/RU2762498C1_20211221
  55. Kutsenok YB. The use of new technologies in the functional treatment of children with congenital hip dislocation under 3 years old. Pediatric Surgery. 2015;3-4(48-49):37–46.
  56. Kilsdonk I, Witbreuk M, Van Der Woude HJ. Ultrasound of the neonatal hip as a screening tool for DDH: how to screen and differences in screening programs between European countries. J Ultrason. 2021;21(85):e147–e153. doi: 10.15557/JoU.2021.0024 EDN: OLTCPH
  57. Pirov RR, Kurbanov SK, Kurbanova RT, Sadirov VZ. The purpose of the study: to study the effectiveness of complex treatment of infants with congenital hip dislocation. Simurg. 2022;(13):38–43. EDN: MCSZVG
  58. Razzokov AA, Karieva MZ. Dynamic splinting for treatment of congenital hip dislocation in children under one year of age. Avicenna Bulletin. 2024;26(1):42–56. doi: 10.25005/2074-0581-2024-26-1-42-56 EDN: CNCNQV
  59. Karieva MZ. Comparative analysis of the results of treatment of congenital dislocation with reduction sprints in children under one year of age. Simurg. 2023;(20):36–44. EDN: QYOZPP
  60. Pavone V, de Cristo C, Vescio A, et al. Dynamic and static splinting for treatment of developmental dysplasia of the hip: a systematic review. Children (Basel). 2021;8(2):104. doi: 10.3390/children8020104 EDN: KSXANS
  61. Merchant R, Singh A, Dala-Ali B, et al. Principles of bracing in the early management of developmental dysplasia of the hip. Indian J Orthop. 2021;55(6):1417–1427. doi: 10.1007/s43465-021-00525-z EDN: LBXDZK
  62. Kamosko MM, Krasnov AI, Baskov VE, et al. The system of treatment of hip dysplasia in children (conception of SRICO N.A. H.I. Turner). Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):26–35. doi: 10.17816/PTORS1126-35 EDN: SJFIDL

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2025 Эко-Вектор


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС77-54261 от 24 мая 2013 г.