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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level IVMust KnowPaediatricsClassification System

Evidence brief

DDH Screening

Developmental Dysplasia of the Hip: Screening and Early Treatment

Authors
Graf R
Journal
Ultraschall Med
Year
1984

Key Findings

  • 1

    Graf classification based on ultrasound morphology

  • 2

    Type I: normal

  • 3

    Type II: immature or mild dysplasia

  • 4

    Type III: subluxation

  • 5

    Type IV: dislocation

  • 6

    Enables early diagnosis before ossification

Clinical Implications

Graf ultrasound classification revolutionized DDH screening, allowing diagnosis and treatment before radiographic changes appear.

Teaching Note

Know Graf classification and angles (alpha >60° = normal, beta <55° = normal). Indications for screening: breech, family history, clinical findings. Treatment: Pavlik harness for Types II-IV under 6 months. Know when Pavlik fails and when to proceed to closed/open reduction.

Citation

Graf R. Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg. 1984;102(4):248-255.

PubMed

Evidence Level

IV

Level IV

Case series or case reports

Topics

DDHultrasoundscreeninghip dysplasiaGraf

Related Topics

  • Developmental Dysplasia Hip
  • Pavlik Harness
  • Hip Ultrasound

External Links

View on PubMed

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