Developmental Dysplasia of the Hip (DDH): The Daily PANCE Blueprint

Home Developmental Dysplasia of the Hip (DDH): The Daily PANCE Blueprint

Developmental Dysplasia of the Hip (DDH): The Daily PANCE Blueprint

A 3-week-old boy is brought in for a routine health visit. He was born to a 30-year-old multigravida at 39 weeks gestation by cesarean delivery for breech presentation. Birth weight was appropriate for gestational age at 3.5 kg (7 lb 11 oz); current weight is 3.8 kg (8 lb 6 oz). Physical examination reveals a positive Ortolani maneuver with a palpable "clunk" on the left hip. An ultrasound of both hips confirms a dislocated left hip with a shallow acetabulum. Which of the following is the best next step in the management of this patient?

A. Immediate closed reduction and spica casting
B. Pavlik harness application
C. Referral for physical therapy
D. Observation and follow-up in 6 months
E. Surgical open reduction

Answer and topic summary

The answer is B. Pavlik harness application

The best next step in the management of a newborn with a confirmed hip dislocation and shallow acetabulum is the application of a Pavlik harness. Patients with DDH require an orthopedics referral for treatment. The Pavlik harness is the first-line treatment for developmental dysplasia of the hip (DDH) in infants younger than 6 months. It maintains the hip in flexion and abduction, allowing the acetabulum to mold around the femoral head and promote normal hip development.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Lower extremity disorders ⇒ Developmental Dysplasia of the Hip

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