Orthonotes
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v3.0 Fusion
v3.0 Fusion
pediatrics topic hub

Developmental Dysplasia of Hip (DDH) — Pavlik to Osteotomy

Early detection with Barlow/Ortolani; ultrasound (Graf) guides treatment under 6 months. Pavlik harness is first‑line for reducible dislocation under ~6 months; avoid excessive extension/abduction to reduce AVN risk. Failed Pavlik → closed reduction and spica; if unstable/obstructed, open reduction with capsulorrhaphy and femoral shortening/derotation as needed. Residual acetabular dysplasia treated with pelvic osteotomies (Salter, Pemberton, Dega) based on age and pathology. Complications: AVN (Kalamchi‑MacEwen), redislocation, stiffness, femoral nerve palsy with Pavlik.

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Early detection with Barlow/Ortolani; ultrasound (Graf) guides treatment under 6 months. Pavlik harness is first‑line for reducible dislocation under ~6 months; avoid excessive extension/abduction to reduce AVN risk. Failed Pavlik → closed reduction and spica; if unstable/obstructed, open reduction with capsulorrhaphy and femoral shortening/derotation as needed. Residual acetabular dysplasia treated with pelvic osteotomies (Salter, Pemberton, Dega) based on age and pathology. Complications: AVN (Kalamchi‑MacEwen), redislocation, stiffness, femoral nerve palsy with Pavlik.
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Question 1

What is the first-line treatment for reducible developmental dysplasia of the hip (DDH) in infants under 6 months?

Question 2

Which clinical test is used to detect a dislocatable hip in infants?

Question 3

What complication is associated with excessive hip abduction and extension in a Pavlik harness?

Question 4

In which situation would you consider performing an open reduction for DDH?

Question 5

Which imaging modality is most useful for diagnosing DDH in infants under 6 months?

Question 6

What is the most common risk factor for developmental dysplasia of the hip?

Question 7

What is the primary goal of treatment for residual acetabular dysplasia in older children?

Question 8

Which sign indicates a dislocated hip when comparing knee heights in a supine infant?

Question 9

What is the Kalamchi-MacEwen classification primarily used for?

Question 10

What is the most important factor in the successful treatment of DDH?