The congenital displasia of the hip or displasia of the development of the hip (DDC) it is the dislocation, subluxation or luxation of the hip on having been born or in the first months of life.

The DDC has causes multifactoriales and is observed by major frequency in:

• the left hip,
• girls,
• the first childbearing,
• buttocks presentations.

The hips incidence luxadas / luxables is of approximately 1:1.000, and that of the hip subluxable is of about 1:100.

In the newborn baby, the maneuvers of Barlow and Ortolani are the most trustworthy for the diagnosis and they must be part of any correct exploration of the nursing healthy one.
It is examined to nursing relaxed and in supine decubitus (knocked down mouth arrives), placing one of the hands of the explorer so that I stabilized the pelvis. Another hand holds the hip that it is necessary to explore with the thumb in the groin and the index or the middle finger on the biggest trocánter (the most prominent protrusion of the femur behind).

• Barlow's sign. Flexiona the hip to 90 grades and it is adduced (it comes closer towards the halfway line) while a soft force is exercised outside with the thumb. During the adduction there can feel the luxation of the hip (sign of positive Barlow).
• Maneuver of reduction of Ortolani. Abduce (it separates of the halfway line) the hip raising it with gentleness. The relocation of the head can feel femoral luxada (what has happened in calling a "click" or crack, which in fact is not heard): maneuver of positive Ortolani.

In the hips subluxables it is possible to feel an extra movement, but that does not constitute a clear reduction or luxation. In the child of 2-3 months of age the muscular tension can mask the luxation or the reduction.

As the child begins to walk, the clinical signs are subtler, although sometimes the asymmetric creases of the thigh are clear or enclosed a knee lower than other one (sign of positive Galleazzi).

Unfortunately, these clinical explorations do not manage to identify all the newborn babies with DDC, partly because any cases pass for high place in the initial exploration and also because any children develop the instability further on.

The radiographies are difficult to interpret until the head femoral begins to ossify 3-6 months after age.

During the dynamic ultrasound scan to evaluate the hip there is used a modified maneuver of Barlow who increases the diagnostic precision in the children with instability of the hip.

In the newborn baby, the instability or luxation of the hip can talk each other with a thong of type Pavlik that is successful in 85-90 % of the nursing ones of up to 6-8 months of age. This thong supports the hips of the nursing one in push-up and abduction, directing the head femoral to the interior of the cruet (his cavity in the pelvis in development). Most of the hips become stable after 2-3 months.

The hips luxadas and diagnosed 6-18 months after age they need a surgical reduction (closed or open) under anesthesia followed by immobilization with a plaster in espica.