UNASSIGNED: Diagnostics and treatment of developmental dysplasia of the hip (DDH) are highly variable in clinical practice. To obtain more uniform and evidence-based treatment pathways, we developed the \'Dutch guideline for DDH in children < 1 year\'. This study describes recommendations for unstable and decentered hips.
UNASSIGNED: The Appraisal of Guidelines for Research and Evaluation criteria (AGREE II) were applied. A systematic literature review was performed for six predefined guideline questions. Recommendations were developed, based on literature findings, as well as harms/benefits, patient/parent preferences, and costs (GRADE).
UNASSIGNED: The systematic literature search resulted in 843 articles and 11 were included. Final guideline recommendations are (i) Pavlik harness is the preferred first step in the treatment of (sub) luxated hips; (ii) follow-up with ultrasound at 3-4 and 6-8 weeks; (iii) if no centered and stable hip after 6-8 weeks is present, closed reduction is indicated; (iv) if reduction is restricted by limited hip abduction, adductor tenotomy is indicated; (v) in case of open reduction, the anterior, anterolateral, or medial approach is advised, with the choice based on surgical preference and experience; (vi) after reduction (closed/open), a spica cast is advised for 12 weeks, followed by an abduction device in case of residual dysplasia.
UNASSIGNED: This study presents recommendations on the treatment of decentered DDH, based on the available literature and expert consensus, as Part 2 of the first official and national evidence-based \'Guideline for DDH in children < 1 year\'. Part 1 describes the guideline sections on centered DDH in a separate article.

OBJECTIVE: To assess the variability in Australian screening guidelines for developmental dysplasia of the hip (DDH).
METHODS: Ovid MEDLINE®, EMBASE, EMB Reviews-Cochrane, CINAHL, TRIP and grey literature were searched to identify screening guidelines for DDH. Key data items related to recommendations for timing and method of screening were extracted and summarised in a table format for qualitative analysis.
RESULTS: Seventeen guidelines met inclusion criteria, comprising nine Australian DDH screening guidelines and eight Child Health Books. The guidelines showed variation in recommendations for the examiner, specific screening methods used for high-risk groups, timing of examinations and recommendations for referral.
CONCLUSIONS: Variability exists within Australian DDH screening guidelines. Lack of knowledge regarding local screening guidelines may contribute to the current trend of increased incidence of late diagnosed DDH in Australia, reported in New South Wales, South Australia, and Western Australia. An evidence-based and consistent approach to DDH screening is necessary to minimise late detected cases.