scholarly journals DISPLASIA PERKEMBANGAN PANGGUL AWAL (LAHIR HINGGA USIA 4 BULAN)

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Vivi Sumarna ◽  
Engeline Angliadi
Keyword(s):  
Early Stage ◽  
Hip Dislocation ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Older Children ◽  
Keywords Hip ◽  
Hip Abduction ◽  
Gait Abnormalities ◽  
Dysplasia Of The Hip

Abstract: Developmental dysplasia of the hip refers to a continuum of abnormalities of the immature hip that can range from subtle dysplasia to dislocation. The identification of risk factors, including breech presentation and family history, should heighten a physician’s suspicion of this condition. The diagnosis is based on physical examination. Palpable hip instability, unequal leg lengths, and asymmetric thigh skinfolds may be present in newborns with a hip dislocation, whereas gait abnormalities and limited hip abduction are more common in older children. The role of ultrasonography is controversial, but it is generally used to confirm the diagnosis and to assess hip development once the treatment is initiated. Bracing is the first-line treatment in children aged less than six months. Surgery is an option for children with unsuccessful non-operative treatment and in children who are diagnosed after six months of age. It is important to confirm the diagnosis of the developmental dysplasia of the hip in the early stage to improve the result of treatment and to decrease the risks of complications. Keywords: hip, developmental dysplasia, immature, instability, bracing   Abstrak: Displasia perkembangan panggul mengacu pada serangkaian abnormalitas pada panggul imatur yang mencakup displasia ringan hingga dislokasi. Identifikasi faktor-faktor risiko yang meliputi letak sungsang dan riwayat keluarga, harus menigkatkan kecurigaan dokter akan displasia perkembangan panggul. Diagnosis ditegakkan melalui pemeriksaan fisik. Instabilitas panggul yang dapat dipalpasi, panjang tungkai yang tidak sama, dan lipatan kulit paha yang asimetris dapat ditemukan pada bayi baru lahir dengan dislokasi panggul, sedangkan abnormalitas gait dan keterbatasan abduksi panggul lebih umum pada anak-anak yang lebih tua. Peran ultrasonografi masih kontroversial tetapi secara umum untuk mengonfirmasi diagnosis dan menilai perkembangan panggul sejak dimulainya perawatan. Penggunaan brace merupakan perawatan lini pertama pada anak-anak berusia kurang dari enam bulan. Pembedahan merupakan pilihan bagi anak-anak dengan perawatan nonoperatif yang gagal dan pada anak-anak yang didiagnosis setelah berusia enam bulan. Displasia perkembangan panggul sangat penting ditegakkan sejak dini untuk meningkatkan hasil perawatan dan mengurangi risiko komplikasi. Kata kunci: panggul, displasia perkembangan, imatur, instabilitas, brace

scholarly journals Developmental dysplasia of the hip

2010 ◽  
Vol 2 (2) ◽  
pp. 19 ◽  
Author(s):  
Shahryar Noordin ◽  
Masood Umer ◽  
Kamran Hafeez ◽  
Haq Nawaz
Keyword(s):  
Positive Family History ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Diagnostic Methods ◽  
Careful Examination ◽  
First Year ◽  
Older Children ◽  
Hip Abduction ◽  
First Year Of Life ◽  
Dysplasia Of The Hip

Developmental dysplasia of the hip (DDH) is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present with limping, joint pain, and/or osteoarthritis. Repeated, careful examination of all infants from birth and throughout the first year of life until the child begins walking is important to prevent late cases. Provocative testing includes the Barlow and Ortolani maneuvers. Other signs, such as shorting of the femur with hips and knees flexed (Galeazzi sign), asymmetry of the thigh or gluteal folds, and discrepancy of leg lengths are potential clues. Treatment depends on age at presentation and outcomes are much better when the child is treated early, particularly during the first six months of life.

scholarly journals Role of arthrography in assessing the closed reduction in treatment of DDH.

2019 ◽  
Vol 26 (12) ◽  
pp. 2184-2187
Author(s):  
Khawar Shahzad ◽  
Rana Dawood Ahmad Khan ◽  
Sajjad Iqbal ◽  
Mazhar Mehmood ◽  
Beenish Israr ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Positive Family History ◽  
Breech Presentation ◽  
Ligamentum Teres ◽  
Developmental Dysplasia ◽  
Musculoskeletal Problems ◽  
Study Setting ◽  
Dysplasia Of The Hip ◽  
Normal Head

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal problems in newborns. It occurs in 1in 1000 live births affecting girls more than boys and more associated with breech presentation and positive family history. Objectives: To evaluate the effectiveness of arthrography in assessing the closed reduction of DDH. Study Design: Clinicial Study. Setting: This study was conducted at Allied Hospital, Faisalabad, Pakistan, Period: From December 2013 to January 2016 and comprised patients of either gender. Material & Methods: DDH was diagnosed with help of clinical examination and radiological investigations. Arthrography was performed and images were taken in different positions of the hip which were evaluated and findings noted. Results: Out of 50 hips, 34 had normal looking head of femur while 16 patients had head of femur which was either smaller than normal or of abnormal shape. Shape of acetabulum was found normal in 41 hips. Normal labrum was present in 44, inverted in 4 and everted in 2 patients. Ligamentum teres was found hypertrophic in 6 patients. Normal head coverage was present in 40 while in 10 hips head of femur was lateralized ≥ 4 mm. No external obstruction to reduction was encountered. In 44 cases reduction was concentric and eccentric reduction was noted in 6 patients. Conclusion: Arthrography is of special help in assessing the reduction of hip in DDH as it provides information about shape of head of femur, shape of acetabulum, labrum, ligamentum teres, containment of the hip, coverage of head and external obstacles to reduction.

Developmental dysplasia of the hip and associated risk factors in Saudi children: A retrospective study

2021 ◽  
pp. 1-8
Author(s):  
Alaa I. Ibrahim ◽  
Eman M. Mortada ◽  
Saeed Abdullah Alqahtani ◽  
Haya Alkathri ◽  
Rania Alsayyed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Positive Family History ◽  
Hip Dislocation ◽  
Breech Presentation ◽  
Female Gender ◽  
Developmental Dysplasia ◽  
P Values ◽  
Dysplasia Of The Hip ◽  
Associated Abnormalities

BACKGROUND: Studies investigating the association between developmental dysplasia of the hip (DDH) and risk factors in Saudi Arabia are rare. OBJECTIVE: Investigate the association between DDH and several risk factors among Saudi children. METHODS: The medical records of 82 children born in or admitted to King Abdul Aziz Medical City in Riyadh, Saudi Arabia with clinical suspicion of hip dislocation (HD) were included. The association between DDH and the following risk factors was investigated: age < 3 y, female-gender, twinning, first-born child, C-section, breech presentation, prematurity, positive family history and presence of associated abnormalities. RESULTS: HD was confirmed in 73 (89%) children (Positive HD) and excluded in 9 (11%) children (Negative HD). Eleven (13.4%) children were excluded from the positive cases as it was confirmed that they have paralytic hip dislocation not DDH. DDH was confirmed in 62 children (75.6%). The Chi square test (χ2) and odds ratios (OR) revealed that the positive family history, female-gender, age < 3 years, and presence of associated abnormalities had significant associations with the presence of DDH with P values and OR equal 0.00 (16.4), 0.002 (3.1), 0.005 (2.6), and 0.04 (1.9) respectively. Breech presentation, twinning, first-born children, prematurity, and C-section were not associated with DDH with P values and OR equal 0.93 (1.1), 0.46 (0.4), 0.11 (0.4), 0.08 (0.3), and 0.002 (0.3) respectively. CONCLUSIONS: Positive family history, female-gender, age < 3 years, and presence of associated abnormalities had approximately 16, 3, 2.5, and 2 times increased risk for DDH.

scholarly journals The potential role of the Alsberg angle as a predictor of lateral growth disturbance of the capital femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction

2020 ◽  
Vol 14 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Ronghua Gui ◽  
Federico Canavese ◽  
Shuang Liu ◽  
Lianyong Li ◽  
Lijun Zhang ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Normal Values ◽  
Developmental Dysplasia ◽  
Lateral Growth ◽  
Growth Disturbance ◽  
Level Of Evidence ◽  
Normal Children ◽  
One Year ◽  
Dysplasia Of The Hip

Purpose Early diagnosis and prevention of lateral growth disturbance of the capital femoral epiphysis is challenging after treatment for developmental dysplasia of the hip (DDH). The aim of the study was to evaluate the radiographic changes of the Alsberg angle (AA) in normal children and those with DDH, and to assess the role of AA as a potential predictor of lateral growth disturbance of the capital femoral epiphysis. Methods AA was measured on the anterior-posterior pelvic radiographs of 1000 normal children ranging in age from one to ten years and in 66 children (92 hips) with DDH treated by closed reduction (CR). A comparative analysis was performed. Results In the normal children, mean AA decreased linearly with age, from 76° at age one year to 65° at age ten years, irrespective of gender and laterality. In children with DDH, the average AA was 81.5°(sd 3.9°; 74° to 87°) prior to CR; it was 75.9° (sd 4.5°; 68° to 83°) in normal children of the same age (p < 0.001). Among the 42 children (64 hips) with successfully and uneventfully treated DDH, AA reached normal values between the ages of five and six years. In contrast, children with lateral growth disturbance of the proximal femur physis (24 children, 28 hips) showed significantly higher AA values in comparison with the age-matched controls. Conclusion In DDH patients with successful CR, AA could be expected to match normal values in children between the ages of five and six years. On the other hand, AA can be used as an early predictor for lateral growth disturbance of the capital femoral epiphysis. Level of Evidence Level III

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.

scholarly journals Acetabular reaming and sartorius muscle pedicle iliac bone grafting in the treatment of developmental dysplasia of the hip in older children: a retrospective study of 15 patients with more than two years follow-up

2020 ◽  
Vol 14 (3) ◽  
pp. 201-207
Author(s):  
Zhang Fan ◽  
Luo Cong ◽  
Liu Hang ◽  
Li Ming ◽  
Wu Jun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Grafting ◽  
Developmental Dysplasia ◽  
Iliac Bone ◽  
Sartorius Muscle ◽  
Acetabular Defect ◽  
Older Children ◽  
Short Term ◽  
Dysplasia Of The Hip

Purpose Despite the early diagnosis and treatment of developmental dysplasia of the hip (DDH), some older children still need open reduction. It is usually difficult to get a satisfactory reduction particularly in patients with acetabular defect. The purpose of this study was to evaluate the short-term outcomes of acetabulum reaming and sartorius muscle pedicle iliac bone grafting in the treatment of older children with DDH and acetabular defect. Methods The records of 15 patients with DDH (mean age 113.9 months (sd 29); 17 hips) who were treated with the reported technique between February 2015 and January 2017 were retrospectively reviewed. All patients acquired regular clinical and radiographic follow-ups, and alterations in the acetabular index, centre-edge angle and acetabular head index were measured. Joint function and radiographic results were evaluated with McKay and Severin modified criteria, respectively. Results A total of 15 patients were followed up for mean 32.4 months (sd 6.9). The percentages of excellent and good conditions were 94.1% (16/17) according to the Severin modified criteria and 88.2% (15/17) according to the McKay modified criteria. Avascular necrosis of the femoral head and redislocation only occurred in one hip. No cases of ankylosis or bone graft absorption occurred during the follow-up. Conclusion Reaming the acetabulum and sartorius muscle pedicle iliac bone grafting for repairing the acetabular defect can recover the arcuate structure by increasing the volume of the acetabulum, which is beneficial for achieving a concentric reduction. The short-term outcome was satisfactory, while the long-term results need to be further observed. Level of Evidence IV – retrospective study

scholarly journals Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Kural ◽  
Esra Devecioğlu Karapınar ◽  
Pınar Yılmazbaş ◽  
Tijen Eren ◽  
Gülbin Gökçay
Keyword(s):  
Risk Factors ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Female Sex ◽  
Dysplasia Of The Hip

Aim. Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods. In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results. A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. Conclusion. According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

scholarly journals Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Michael Müller ◽  
Anasthasia Rakow ◽  
Georgi I. Wassilew ◽  
Tobias Winkler ◽  
Carsten Perka
Keyword(s):  
Early Stage ◽  
Treatment Options ◽  
Developmental Dysplasia ◽  
Prosthesis Implantation ◽  
Secondary Osteoarthritis ◽  
Time Of Surgery ◽  
Hip Anatomy ◽  
The Mean ◽  
The Relationship ◽  
Dysplasia Of The Hip

Abstract Background Developmental dysplasia of the hip (DDH) can lead to pain and premature secondary osteoarthritis at an early stage. Joint-preserving osteotomy is an established solution to this problem. In contrast, a conservative approach would result in pain persistence, ultimately raising the patients question for a possible date of expected prosthesis implantation. The aim of the study was to identify the relationship between the dysplastic hip anatomy and the time of prosthesis implantation in order to enable prognostic predictions in younger patients with symptomatic DDH. Materials and methods Data from 129 hips who received THA due to secondary DDH osteoarthritis were evaluated. The preoperative hip anatomy was evaluated for AI and LCE angle. Multiple linear regression analyses were then used to correlate the influence of these parameters with the patient’s age at the time of surgery. In addition, a graphical relationship was derived by the method of power least squares curve fitting with second-degree polynomials. Results The mean age for THA was 54.3 ± 11 years. The time of surgery correlated significantly with LCE (0.37) and AI (− 0.3) (p < 0.001). The mean age of patients with LCE angle ≤ 10° was 41.9 ± 14.0 years, for LCE 11–20° 52.7 ± 9.5 years, and for LCE 21–30° 57.0 ± 10.3 years. The following formula could then be determined for the calculation of the potential patient age at the time of THA as a function of LCE angle: age pTHA = 40.2 + 0.8 × LCE angle − 0.01 × (LCE angle)2. Conclusion A significant correlation between the extent of dysplasia and the time of prosthesis implantation was identified. In particular, the LCE and the AI correlated strongly with the time of implantation. The more dysplastic the angles were, the sooner the THA was necessary. Using the calculations presented in this study, the probable age of prosthesis implantation can be prognosticated and included in a counseling session about treatment options for DDH.

Sign in / Sign up

Export Citation Format

Share Document