scholarly journals Developmental Hip Dysplasia: An Epidemiological Nationwide Study in Italy from 2001 to 2016

2021 ◽  
Vol 18 (12) ◽  
pp. 6589
Author(s):  
Umile Giuseppe Longo ◽  
Rocco Papalia ◽  
Sergio De Salvatore ◽  
Laura Ruzzini ◽  
Ilaria Piergentili ◽  
...  
Keyword(s):  
Hip Dysplasia ◽  
Epidemiological Studies ◽  
Developmental Dysplasia ◽  
Limited Data ◽  
Public Database ◽  
National Hospital ◽  
International Consensus ◽  
Developmental Hip Dysplasia ◽  
Screening Protocol ◽  
Dysplasia Of The Hip

Developmental Dysplasia of the Hip (DDH) includes a broad spectrum of hip abnormalities. DDH requires early diagnosis and treatment; however, no international consensus on screening protocol and treatment is provided in the literature. Epidemiological studies are helpful to understand the national variation of a specific surgical procedure and compare it with that of other countries. Data provided by different countries could allow researchers to provide international guidelines for DDH screening and treatment. Limited data are reported regarding trends of hospitalization for DDH, and no public database is available. The purpose of this study was to estimate annual admissions for DDH in Italian patients from 2001 to 2016, based on the hospitalization reports. Data of this study were collected from the National Hospital Discharge Reports (SDO) reported at the Italian Ministry of Health. Descriptive statistical analyses were performed. From 2001 to 2016, 3103 hospitalizations for DDH were recorded in Italy, with a mean incidence of 2.33 (per 100,000 young inhabitants). Females of the 0–4 years old group represented the majority of patients hospitalized for DDH.

scholarly journals Developmental hip dysplasia in adolescence

2009 ◽  
Vol 137 (7-8) ◽  
pp. 440-443 ◽  
Author(s):  
Zoran Vukasinovic ◽  
Zorica Zivkovic ◽  
Cedomir Vucetic
Keyword(s):  
Hip Dysplasia ◽  
Developmental Dysplasia ◽  
Pathological Findings ◽  
Leg Length ◽  
Treatment Results ◽  
Developmental Hip Dysplasia ◽  
Treatment Protocols ◽  
Management Modes ◽  
Dysplasia Of The Hip

The authors define adolescence and developmental dysplasia of the hip (DDH). Special attention is paid to pathological findings characteristic of DDH in adolescence (unrecognized and untreated DDH; treated DDH, but non-terminated treatment; DDH diagnosed with delay, inadequately treated, with complications). The authors emphasise that DDH treatment has to be successfully terminated well before the adolescence; possibilities are explained on management modes at the time of adolescence, and possible persons guilty for the persistence of later hip problems are indicated. Based on the authors' experience and having in mind all surgical possibilities for the treatment (pelvic osteotomies, femoral osteotomies, trochanteroplasties, leg length equalization procedures) the authors propose treatment protocols. The intention is to provide better treatment results and to prevent secondary hip arthrosis. Furthermore, how to improve the struggle against DDH is suggested.

scholarly journals Developmental dysplasia of the hip - clinical management and ultrasound screening

2001 ◽  
Vol 3 (10) ◽  
pp. 324-328
Author(s):  
P Marshall ◽  
S Wildon
Keyword(s):  
Hospital Care ◽  
Hip Dysplasia ◽  
Screening Programme ◽  
Developmental Dysplasia ◽  
Ultrasound Screening ◽  
National Guidelines ◽  
Developmental Hip Dysplasia ◽  
Clinical Screening ◽  
Health Visitors ◽  
Dysplasia Of The Hip

Although there is an agreed national protocol for the clinical screening of developmental hip dysplasia (DDH) there are no national guidelines for the use of ultrasound to detect this condition. The increased incidence of babies requiring surgery for this condition across the bay has led us to institute a selective screening programme in line with best clinical practice. This article describes care pathways in primary and hospital care in some detail and will therefore be of direct clinical relevance to the midwive , health visitors, general practitioners, physiotherapists, paediatricians, and orthopaedic surgeons involved in the management of babies at higher risk of DDH. We also outline the physiotherapy and orthopaedic management of children with this condition. Feedback or suggestions relating to the recently introduced screening programme would be welcomed.

scholarly journals The results of total arthroplasty for developmental dysplasia of the hip

TRAUMA ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 5-9
Author(s):  
A.I. Kanziuba ◽  
D.A. Yurchenko
Keyword(s):  
Hip Dysplasia ◽  
Developmental Dysplasia ◽  
Average Score ◽  
Successful Implementation ◽  
Main Task ◽  
Type I ◽  
Developmental Hip Dysplasia ◽  
Rehabilitation Treatment ◽  
Total Arthroplasty ◽  
Dysplasia Of The Hip

Background. In developmental dysplasia of the hip joint in adults, total arthroplasty is recognized as a non-alternative surgical intervention. In scientific and practical aspects, the main task of arthroplasty is the maximum restoration of musculoskeletal function or compensation of biomechanical disorders, as well as providing conditions for the long-term preservation of the stability of the implant. The purpose of this work is to investigate the factors that determine the results of total arthroplasty for developmental hip dysplasia in the middle follow-up period. Materials and methods. There were examined 84 patients who underwent total hip arthroplasty for developmental hip dysplasia during 2014–2019. The timing for evaluating the results was chosen based on the observations that a certain stable level of the achieved result is formed in the period from 1 to 3 years, depending on the severity of the anatomical disorders. Results. A total of 116 total arthroplasty operations were performed. Of these, there were dysplasia Crowe type I in 52 (44.8 %) cases, type II — in 34 (29.4 %), type III — in 26 (22.4 %), type IV — in 4 (3.4 %) cases. The concept of the study was to study the factors that influence the choice of surgical tactics, especially after surgical rehabilitation treatment and functional results in the medium term. Generalized results on the W. Harris scale are as follows: excellent (average score 92.3) — 39 (46.4 %), good (average score 86.6) — in 26 (30.9 %), satisfactory (average score 78.3) — in 15 (17.9 %), unsatisfactory (average score 67.4) — in 4 (4.8 %). The condition of the bone and soft tissues of the hip as well as the degree of anatomical abnormalities are critical for the successful implementation of arthroplasty. After arthroplasty for II and III types of dysplasia, limping, leg length discrepancy, and a feeling of muscle weakness are observed. They are caused by such factors as asymmetric hip rotation, violation of the femoral offset, scoliotic deformity of the lumbar spine. Conclusions. After arthroplasty for hip dysplasia, patients need more prolonged rehabilitation treatment and the results of arthroplasty are determined by the degree of compensation of anatomical and functional disorders achieved.

scholarly journals Sequential one-stage combined procedure for treating bilateral developmental hip dysplasia after walking age

2019 ◽  
Vol 47 (7) ◽  
pp. 2901-2909
Author(s):  
Haibing Li ◽  
Wensong Ye ◽  
Lujie Xu ◽  
Li Li ◽  
Weiwei Zhu ◽  
...  
Keyword(s):  
Hip Dysplasia ◽  
Operative Time ◽  
Developmental Dysplasia ◽  
Developmental Hip Dysplasia ◽  
Combined Procedure ◽  
One Stage ◽  
Walking Age ◽  
The Mean ◽  
Two Sides ◽  
Dysplasia Of The Hip

Objective This study aimed to evaluate outcomes of the sequential one-stage combined procedure for treating bilateral developmental dysplasia of the hip (DDH) that was diagnosed after walking age. Methods Thirty-five patients (70 hips) with late-presenting bilateral DDH were treated with the sequential one-stage combined procedure. Hips were reclassified according to the operative time and divided into the first and the second operated hips. The outcomes were compared clinically and radiographically between the two sides preoperatively and postoperatively. Results The mean interval time between the two procedures was 5.9 months (range: 2–9 months). The first operated hip achieved better results than did the second operated hip. A total of 68.6% (24/35) of the patients in our series had an asymmetric outcome. Conclusions The sequential one-stage combined procedure is a challenge, but a reasonable alternative surgery for bilateral DDH in children after walking age. An asymmetric outcome is a special complication of this procedure.

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.

Description of the ‘pronation manoeuvre’ for the diagnosis of developmental hip dysplasia

2021 ◽  
Author(s):  
José Fernando de-la-Garza-Salazar ◽  
Julieta Rodríguez-de-Ita ◽  
Bárbara M Garza-Ornelas ◽  
Jorge A Martínez-Cardona
Keyword(s):  
Physical Examination ◽  
Developmental Dysplasia ◽  
Clinical Tool ◽  
Developmental Hip Dysplasia ◽  
Cross Sectional ◽  
Diagnosis And Prognosis ◽  
Screening Strategies ◽  
Hip Ultrasound ◽  
Low Sensitivity ◽  
Dysplasia Of The Hip

Abstract Introduction Without a prompt diagnosis, developmental dysplasia of the hip (DDH) in infants can lead to severe sequelae. Current screening strategies emphasize the use of Ortolani and Barlow physical examination manoeuvres, yet they exhibit low sensitivity. The purpose of this study is to evaluate the performance of a new physical examination tool (the pronation manoeuvre) as a screening tool for DDH. Methods To evaluate the new manoeuvre, a cross-sectional and analytic study was performed with a nonprobabilistic sampling method. Patients with either a positive Ortolani or Barlow manoeuver were evaluated with the new manoeuvre and hip ultrasound. Controls were infants with negative Ortolani, Barlow and pronation manoeuvres and also had ultrasound performed. Results DDH was confirmed in 83 of 130 cases (64%) and 2 of 130 controls (2%). The new pronation manoeuvre had a sensitivity of 76% and a specificity of 94% as compared to the Ortolani and Barlow manoeuvres (sensitivity 31 to 32%, specificity 93 to 100%) (P<0.05). Conclusion This new physical examination manoeuvre could serve as another clinical tool for the initial screening of DDH in newborns. Its promising results against traditional screening procedures might potentially impact diagnosis and prognosis for patients with DDH.

Developmental Hip Dysplasia

2019 ◽  
pp. 297-300
Author(s):  
Dorothy L. Gilbertson-Dahdal
Keyword(s):  
Risk Factors ◽  
Problem Solving ◽  
Imaging Modality ◽  
Treatment Options ◽  
Hip Dislocation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Developmental Hip Dysplasia ◽  
Hormonal Factors ◽  
Dysplasia Of The Hip

Chapter 112 focuses on developmental dysplasia of the hip, which includes a spectrum of abnormalities ranging from a stable hip with a mildly dysplastic acetabulum to complete hip dislocation. Pathophysiology, clinical findings, and screening studies are explored. The pathophysiology is multifactorial including mechanical, genetic and hormonal factors. Imaging strategies, findings, and treatment options are also discussed. Screening US, which is the imaging modality of choice, is performed on infants with predisposing risk factors. Outcome is quite variable with many cases resolving spontaneously without treatment whereas others stabilize with acetabular dysplasia. Treatment options include immobilization and surgery. MRI is used for problem solving in postoperative patients.

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.

scholarly journals Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study

2019 ◽  
Vol 13 (2) ◽  
pp. 161-166 ◽  
Author(s):  
H. Ömeroğlu ◽  
A. Akceylan ◽  
N. Köse
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Hip Dysplasia ◽  
Positive Family History ◽  
Significant Risk ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Dysplasia Of The Hip

Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened. Level of Evidence Level III prognostic study

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