scholarly journals Neonatal hip dysplasia: Differental diagnosis

2010 ◽  
Vol 138 (9-10) ◽  
pp. 609-613
Author(s):  
Milos Pajic ◽  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Zorica Zivkovic
Keyword(s):  
Hip Dysplasia ◽  
Ultrasound Examination ◽  
Neonatal Period ◽  
Developmental Dysplasia ◽  
Clinical Tests ◽  
Prevention And Treatment ◽  
Neonatal Hip ◽  
Elementary Form ◽  
Dysplasia Of The Hip

Introduction. Hip dysplasia is the elementary form of the developmental dysplasia of the hip (DDH). The diagnosis may be made by the ultrasound examination (types II a-, II b). Objective. The aim of the authors was to define the congenital structural neonatal hip dysplasia, and to differentiate hip hypoplasia, hip dysplasia and teratogenic anomalies. Methods. In all the cases, the uniform clinical and ultrasound tests were performed. All the patients were examined in the neonatal period of life (the first six weeks). The following clinical tests were used: Le Damany-Ortolany, Coleman-Barlow-Palmen and Weissman-Strinovic. For the ultrasound examination, the Graph?s method was used. Results. The investigation was performed in the period 2007- 2008. 2,878 neonates were included. The distribution of the sonotypes, according to Graph, was as follows: Ia in 16.17%. Ib in 65.08%; IIa+ in 18.17%, IIc in 0.28%, IId in 0.19%; IIIa in 0.009%, IIIb in 0.02%; and IV in 0.01%. It was found that DDH was 8 times more frequent in girls; located more frequently at the left side than bilaterally. Conclusion. Hip sonoscreening has to be performed in all newborns in the first 72 hours. The suggested follow-up period is six weeks: for the diagnosis - the first three weeks, and for the prevention and treatment - all six weeks.

Radiological Outcomes of Overhead Traction Therapy for Developmental Dysplasia of the Hip in Non-ambulatory Children

2017 ◽  
Vol 19 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Marcin K. Waśko ◽  
Szymon Pietrzak ◽  
Anna Szarejko ◽  
Waldemar Przybysz ◽  
Tomasz Parol ◽  
...  
Keyword(s):  
Hip Dysplasia ◽  
Statistical Tests ◽  
Plaster Cast ◽  
Developmental Dysplasia ◽  
Type I ◽  
Femoral Metaphysis ◽  
Acetabular Angle ◽  
Final Treatment ◽  
Dysplasia Of The Hip

Background. Infants with a dislocated and unstable hip that does not lend itself to stabilisation may be treated using overhead traction to achieve gradual reduction of the hip joint. The aim of this paper was to analyse the radiological outcomes of overhead traction therapy and the effect of duration of traction on the occurrence of complications and final treatment outcomes. Material and methodd. A retrospective analysis of medical records of 26 children (34 affected hips) involved three independent observers assessing radiological parameters before the surgery and at follow-up visits at least two years after the therapy. Results. Overhead traction was used for an average of 35 days (range: 15-43 days). Twenty six hips were treated solely with reduction and immobilisation in a ‘human position’ plaster cast. Three hips were qualified for surgery immediately after a preliminary traction period. Five hips showed a suboptimal result following the immobilisation period. A MANOVA model revealed that the following factors had a significant effect on the treatment outcome: superior centring ratio of Smith (with the lowest values recorded in patients with residual hip dysplasia, p = 0.001) and acetabular angle of Sharp (with the lowest values found in patients requiring surgery, p = 0.01). Statistical tests did not show a correlation between the duration of traction and disturbance of proximal femoral metaphysis growth assessed according to Bucholz and Ogden classification. Fifteen hips were classified as type I, eight hips were graded as type II and also eight hips as type III. Conclusions. The lowest values of acetabular angle of Sharp were recorded in patients requiring surgery and the lowest superior centring ratio of Smith was found in those with residual hip dysplasia. The duration of overhead traction did not directly correlate with the final outcome; it only seemed to be an indicator of the severity of hip dysplasia. Routine use of overhead traction before undertaking closed reduction does not probably decrease the incidence of proximal femoral growth disturbance.

Ultrasound examination of neonatal hip: correlation of twin pregnancy and congenital dysplasia

Twin Research ◽  
2000 ◽  
Vol 3 (1) ◽  
pp. 7-11 ◽  
Author(s):  
O Rühmann ◽  
D Lazović ◽  
P Bouklas ◽  
S Schmolke ◽  
CH Flamme
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Premature Birth ◽  
Twin Pregnancy ◽  
Hip Dysplasia ◽  
Ultrasound Examination ◽  
Twin Research ◽  
The Family ◽  
Neonatal Hip ◽  
Dysplasia Of The Hip

AbstractTwin pregnancy is considered to be a risk factor for congenital dysplasia of the hip. From 1987 until 1996, the hips of 4476 (2260 male, 2216 female) newborn babies were examined by ultrasound according to Graf's technique and classification in our hospital. In this study, we compare the results of twins and singletons for this risk factor. Of the newborns, 97 (2.2%) were twins (40 male, 57 female); 39 pairs of twins (10 male/male, 19 female/female, 10 male/female) and 19 individual twins (6 male, 13 female) were investigated. Hips of typeIa, Ib and IIa (α ≥ 55°) are not pathologic; hips of typeIIa (α < 55°) need an early control examination; and hips of typeIIc, D, IIIa, IIIb and IV require therapy. TypesIa, Ib, and IIa (α ≥ 55°) were found in 4207 (94.0%) of all newborns, in 4112 (93.9%) of the singletons, and in 95 (97.9%) of the twins. Early control examination and/or therapy (indicated for typesIIa (α < 55°), IIc, D, IIIa, IIIb, and IV) were necessary in 269 (6.0%) of all cases, in 267 (6.1%) of singletons and two (2.1%) of twins. Twins with additional factors such as breech position birth, hip dysplasia in the family or premature birth did not show the types of hip IIa (α < 55°), IIc, D, IIIa, IIIb, IV. We did find these hips in two (3.5%) of the female twins, but not at all in the male twins. Statistically, twins with or without other risk factors that are known before birth did not show significantly more of type hip IIa (α < 55°), IIc, D, IIIa, IIIb, IV (P > 0.05). Twin Research (2000) 3, 7–11.

THE CHIARI PELVIC OSTEOTOMY

1999 ◽  
Vol 03 (01) ◽  
pp. 1-10
Author(s):  
I. Y. Ok ◽  
C. H. Jeong ◽  
H. Y. Lee
Keyword(s):  
Cerebral Palsy ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Delayed Union ◽  
Developmental Dysplasia ◽  
Painful Hip ◽  
Good Coverage ◽  
Dysplasia Of The Hip ◽  
Chiari Pelvic Osteotomy

The result of 27 Chiari pelvic osteotomy were analyzed to determine the efficacy of the operation in the treatment of subluxated and/or painful dysplastic hips. The length of follow-up ranged from 2 to 14 years. Eighteen patients had had developmental dysplasia of the hip; four sequelae of the septic hip; two, cerebral palsy and one had had poliomyelitis. The osteotomy can be done by power saw and osteotome. A large threaded K-wire was used for internal fixation. Bone graft was necessary even with the displacement of more than 50%. The overall result were: 12, excellent; 8, good; 5, fair; and 2 poor. In 11 patients, the osteotomy had to be displaced more than 50% to provide good coverage of the femoral head. There were no major complications such as sciatic nerve injury or delayed union. This procedure is most suited for the patient with painful hip dysplasia in whom a concentric reduction is not possible.

scholarly journals Outcomes and complications of patients undergoing Salter’s innominate osteotomies for hip dysplasia: a systematic review of comparative studies

2021 ◽  
Author(s):  
Tushar Tejpal ◽  
Ajaykumar Shanmugaraj ◽  
Arnav Gupta ◽  
Nolan S Horner ◽  
Nicole Simunovic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Dysplasia ◽  
Developmental Dysplasia ◽  
Normal Range ◽  
Center Edge ◽  
Younger Age ◽  
Technical Factors ◽  
Dysplasia Of The Hip ◽  
Center Edge Angle

Abstract The purpose of this systematic review is to assess outcomes and complications of patients undergoing Salter’s innominate osteotomies (SIOs) for the correction of hip dysplasia along with patient and technical factors that can be optimized to improve outcomes after SIO. MEDLINE and EMBASE were searched from data inception to 9 October 2018. Data were presented descriptively. Twenty-seven studies were identified including 1818 hips (87.1%) treated with SIO (mean age of 2.1 ± 2.5 years and mean follow-up of 3.5 ± 5.0 years). Patients undergoing SIO had a post-operative center-edge angle (CEA) of 31.3° ± 5.3° and an acetabular index (AI) angle of 16.1° ± 5.2°. Patients undergoing SIO with pre-operative traction had significantly lower (P = 0.049) post-operative McKay criteria scores compared to patients without pre-operative traction. Patients undergoing SIO between the ages of 1.5–2 years had significantly better (P &lt; 0.05) post-operative McKay criteria scores compared to patients aged 4–6 years. The complication rate was 9.4% with avascular necrosis (2.5%) being most common. This review found that SIO for developmental dysplasia of the hip produces generally good post-operative clinical outcomes. The CEA and AI can be corrected to normal range after SIO. Patients may have superior outcomes if they have SIO at a younger age, were not treated with pre-operative traction and did not have untreated contralateral hip dysplasia. Outcomes appear to be similar between one-stage bilateral SIO and a two-stage procedure in the setting of bilateral hip dysplasia; however, more multicentered studies are needed to confirm these results.

scholarly journals Timing of Repeat Ultrasound Examination in Treatment of Stable Developmental Dysplasia of the Hip

2021 ◽  
Vol 41 (4) ◽  
pp. 203-208
Author(s):  
Wesley W.E.S. Theunissen ◽  
Marieke van der Steen ◽  
Florens Q.M.P. van Douveren ◽  
Adhiambo M.A. Witlox ◽  
Jaap J. Tolk
Keyword(s):  
Ultrasound Examination ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

scholarly journals Should We Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

2021 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Clinical Examination ◽  
Hip Dysplasia ◽  
Screening Programme ◽  
Developmental Dysplasia ◽  
The Other ◽  
Idiopathic Clubfoot ◽  
Ultrasound Screening ◽  
Review Of The Literature ◽  
Targeted Ultrasound ◽  
Dysplasia Of The Hip

Objective: The association between clubfoot and developmental dysplasia of the hip (DDH) remains uncertain, with only a few studies linking both. However, clubfoot is considered as a risk factor for DDH. The aim of this study was to determine the incidence of DDH and evaluate the need for routine hip imaging in our population of children with clubfoot. Methods: Retrospective analysis of all patients treated for clubfoot in our center between 2010 and 2019. We included patients with hip imaging for DDH in the first 12 months of life. Results: There were 108 children with clubfoot who underwent DDH screening. 92 had idiopathic clubfoot and 16 had syndromic clubfoot. Of the patients with idiopathic clubfoot, 2 (2.2%) had DDH; one had a clinically unstable hip and the other patient underwent hip screening on account of the clubfoot alone. Among patients with syndromic clubfoot, 3 (18.8%) had developmental dysplasia of the hip. Two of them had an abnormal hip examination while the other had normal hip clinical examination but other established risk factors for DDH. Conclusion: A targeted ultrasound or radiological screening programme for DDH in idiopathic clubfoot diagnosed hip dysplasia in only 1 child that would have otherwise been missed by clinical examination alone. We conclude that hip imaging is not warranted in children with idiopathic clubfoot and regular clinical screening may suffice. In syndromic clubfoot, due to the higher incidence of DDH, we recommend specific ultrasound screening even in the presence of a normal hip examination. Keywords: Clubfoot, Screening, Developmental dysplasia of the hip.

Outcomes of closed reduction in patients with developmental dysplasia of the hip incorporating open psoas and adductor release and using short leg cast

2021 ◽  
Vol 15 (5) ◽  
pp. 1529-1532
Author(s):  
M. S. Abdulqader ◽  
L. J. Khorsheed ◽  
Hwaizi .
Keyword(s):  
Soft Tissue ◽  
Closed Reduction ◽  
Case Series ◽  
Developmental Dysplasia ◽  
Soft Tissue Release ◽  
Plaster Of Paris ◽  
Dysplasia Of The Hip ◽  
Mid Term Results ◽  
Tönnis Grade

Background and objectives: Closed reduction and short leg spica casting are the preferred treatment options for children with developmental dysplasia of the hip. This study aimed to show the efficacy behind a standardized closed reduction for managing patients with developmental dysplasia of the hip with concomitant soft tissue releases when indicated and using a short leg plaster of Paris cast to maintain reduction and reporting mid-term results. Methods: A case series of 95 hips in 84 children aged 6-18 months who had closed reduction, with five years follow up or until next operation, involved in this study. The protocol defines acceptable concentric reduction criteria and the indications for an associated soft tissue release. All the patients were immobilized in a short leg cast for three months. Multiple follow-up radiographs were taken to assess Tönnis grade, Severin grade, acetabular index, and osteonecrosis signs. Results: A total of 48 hips were Tönnis grade 3/4 hips. At one year, 15 reductions couldn’t be maintained, and these patients needed open reduction. Of these 15 failed reductions, 7 patients were Severin 1; others were Severin 2. Of the 80 successful closed reductions, 70 hips were Severin 1. Surgical management for residual dysplasia was offered for 8 hips. Osteonecrosis was seen in 23 hips but was transient in 20. Bilateral hip dislocations and most Tönnis 4 hips were more likely to fail. Two children had severe osteonecrosis. Conclusions: Closed reduction, with subsequent adductor and psoas releases, when indicated and using a short leg plaster of Paris cast for three months, brings about good mid-term results in children with developmental dysplasia of the hip aged 6-18 months. Keywords: Developmental dysplasia of the hip, closed hip reduction, open psoas release, short leg cast.

Prevalence of Hip Ultrasound Abnormalities in Newborns With a Hip Click

2020 ◽  
Vol 59 (8) ◽  
pp. 773-777
Author(s):  
John T. Gaffney ◽  
John Spellman
Keyword(s):  
Family History ◽  
Confidence Interval ◽  
Physical Examination ◽  
Prospective Studies ◽  
Hip Dysplasia ◽  
Developmental Dysplasia ◽  
Inclusion Criteria ◽  
History Of ◽  
Hip Ultrasound ◽  
Dysplasia Of The Hip

A hip click on examination of the newborn hip is believed to be the result of a ligament or myofascial structure and thought to be benign. Some studies suggest a link between hip clicks and developmental dysplasia of the hip. The purpose of our study is to estimate the prevalence of ultrasound hip abnormalities in newborns with a hip click and an otherwise normal physical examination. Results. Ninety patients meeting inclusion criteria of a hip click with an otherwise normal physical examination underwent diagnostic ultrasound with a 17.8% prevalence of hip abnormalities found (95% confidence interval ±7.9% [range of 9.9% to 25.7%]). Our study had 64 (71%) females and 26 (29%) males. The prevalence of hip pathology for females was 18.8% (12 of 64 patients) and for males was 15.4% (4 of 26 patients). Thirty-three patients were found to have bilateral hip clicks on presentation, with 21.2% (7 of 33) of those patients found to have hip pathology on ultrasound (3 of the 7 had pathology of both hips). Six patients had a family history of hip dysplasia and 1 of these patients (16.7%) had pathology on ultrasound. The average age to hip sonography was 6.6 weeks. Conclusions. In all, 17.8% of newborns with a hip click were found to have hip abnormalities on ultrasound. The prevalence of hip pathology, on ultrasound, suggests that additional larger, prospective studies are needed to clarify the association between a hip click and abnormal ultrasound found at 6 weeks of age or greater.

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