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A range of cases of DDH from an archaeological Native American population are described and the clinical and prehistoric prevalence of DDH among indigenous populations of North America are calculated and discussed within a biocultural perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pelves of 390 adults from the Late Prehistoric (1490 B.P.\u2009\u00b1\u200970) Buffalo site, West Virginia, were examined for DDH. Morphology of true and false acetabula was classified and other changes of the pelvis, lower limb, and spine were noted along with cranial deformation, providing evidence of infant restriction. Prevalence of DDH among living and archaeological indigenous peoples of North America were calculated and compared. Cranial deformation was assessed as evidence for swaddling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>DDH was identified in 18 adults from Buffalo, resulting in a minimum prevalence of 46.15 per 1,000, within the range reported in modern indigenous groups in North America. Most, but not all, of the DDH cases were associated with cranial deformation, but not all cases of cranial deformation were associated with DDH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The etiology of DDH suggests that components of both genetic predisposition and swaddling practices have combined to create a high\u2010risk environment for the development of DDH, contributing to high prevalence within archaeological populations, like Buffalo, and modern Indigenous groups of North America. Am. J. Hum. Biol. 27:116\u2013128, 2015. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajhb.22622","type":"journal-article","created":{"date-parts":[[2014,9,15]],"date-time":"2014-09-15T12:21:48Z","timestamp":1410783708000},"page":"116-128","source":"Crossref","is-referenced-by-count":20,"title":["To swaddle, or not to swaddle? paleoepidemiology of developmental dysplasia of the hip and the swaddling dilemma among the indigenous populations of <scp>N<\/scp>orth <scp>A<\/scp>merica"],"prefix":"10.1002","volume":"27","author":[{"given":"Samantha H.","family":"Blatt","sequence":"first","affiliation":[{"name":"Department of Anthropology Boise State University Boise Idaho 83725\u20101950"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,15]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"275","article-title":"Incidence of congenital dislocation of the hip in Shiraz","volume":"9","author":"Abdinejad F","year":"1996","journal-title":"Med J Islamic Repub Iran"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01633414"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200201000-00019"},{"key":"e_1_2_7_5_1","volume-title":"Prevention of congenital dislocation of the hip in infants: experience and results in Japan. 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