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P29 International interdisciplinary consensus meeting on evaluation of developmental dysplasia of the hip
  1. Joseph O’Beirne1,
  2. Konstantinos Chlapoutakis2,
  3. Sattar Alshryda3,
  4. Ustun Aydingoz4,
  5. Thomas Baumann5,
  6. Pranai Buddhev6,
  7. Carolina Casini7,
  8. Maurizio de Pelligrin8,
  9. Beat Dubs9,
  10. Reinhard Graf10,
  11. Sandeep Hemmadi11,
  12. Apostolos Karantas12,
  13. Stylianos Kolovos13,
  14. Zhao Liang14,
  15. Claudia Maizen15,
  16. Thara Persaud16,
  17. Richard Placzek17,
  18. Sally Scott18,
  19. Raoul Schmid19,
  20. Ailbhe Tarrant20
  1. 1University Hospital Waterford, Waterford, Ireland
  2. 29, Arkoleontos Str, Heraklion, Greece
  3. 3Al Jalila Children’s Specialty Hospital, Dubai, UAE
  4. 4Hacettepe University School of Medicine, Ankara, Turkey
  5. 5Rigistraasse 15, Baar, Switzerland
  6. 6Royal Children’s Hospital, Melbourne, Australia
  7. 7Ospedale Sant Andrea, Rome, Italy
  8. 8Ospedale San Raffaele, Milan, Italy
  9. 9Sonographie Institut Glattpark, Zurich, Switzerland
  10. 10Stolzalpe, Murau, Austria
  11. 11University Hospital of Wales, Cardiff, UK
  12. 12University of Crete, Heraklion, Greece
  13. 13Private University Consortium, Larissa, Greece
  14. 14LinYi Ttraditional Chinese Medicine Hospital, Lin’yi, China
  15. 15Royal London Hospital, London, UK
  16. 16Tallaght Hospital, Dublin, Ireland
  17. 17Klinik und Polyklinik fur Orthopadie und Unfallchirugie, Bonn, Germany
  18. 18Royal Dorset County Hospital, Dorchester, UK
  19. 19Rigistraase 15, Baar, Switzerland
  20. 20Rotunda Hospital, Dublin, Ireland


There is substantial disagreement about several aspects of Developmental Dysplasia of the Hip (DDH), including its etiology, policies for detection, and treatment. Introduction of hip ultrasound (US) as a diagnostic and screening tool, opened a new era in the field of early diagnosis and effective treatment.

In September 2018 an international meeting of medical doctors of various disciplines, with expertise in the detection and treatment of DDH, was held in Csolyospalos, Hungary. The aim was to arrive at a consensus on these topics, to develop a standardized system of teaching and training in hip US, and to work towards the maintenance of quality in all these areas.

It was agreed that etiology of the condition is multifactorial; the role of recognized risk factors, in particular breech presentation, female sex and (first degree) family history was recognised.

There was strong agreement that clinical examination alone is inadequate, and that screening by US is essential. Specifically Graf’s techinque of hip US was selected as the US technique of choice.

Universal US screening was strongly favoured. Screening should be carried out as soon as possible, but not later than the sixth week of age. US screening is cost-effective, does not result in overtreatment, and contributes to substantially reducing long term consequences.

Essential principles of treatment consist of timely application of a device to achieve reduction, retention and maturation, by holding the hips in flexion, and a safe degree of abduction.

Finally, it was agreed that effectiveness of any screening policy heavily depends on the correct application of the scanning technique, so standardization of teaching and training in Graf’s technique is considered mandatory. A unified teaching policy and materials will be developed for this purpose. Certification, re-certification and audit have been thoroughly discussed.

The group, which has been formalized as the International Interdisciplinary Consensus Committee for DDH Evaluation (ICODE), will continue to meet, and work towards establishing international consensus on DDH, towards standardizing and developing teaching and training in the Graf’s technique of hip US, and towards the maintenance of standards in detection and management of DDH.

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