An Unusual Cause of Neonatal HIP Dislocation: Infantile Myofibromatosis Presenting as Developmental Dysplasia of the HIP

2016 ◽  
Vol 26 (5) ◽  
pp. e39-e41 ◽  
Author(s):  
Timothy Woo ◽  
Thuzar Win
Keyword(s):  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Infantile Myofibromatosis ◽  
Neonatal Hip ◽  
Dysplasia Of The Hip

scholarly journals Open reduction for developmental dysplasia of the hip: failures of screening or failures of treatment?

2013 ◽  
Vol 95 (2) ◽  
pp. 113-117 ◽  
Author(s):  
AP Sanghrajka ◽  
CF Murnaghan ◽  
A Shekkeris ◽  
DM Eastwood
Keyword(s):  
Open Reduction ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Early Management ◽  
Street Hospital ◽  
Great Ormond Street Hospital ◽  
Maternity Hospitals ◽  
Neonatal Hip ◽  
Dysplasia Of The Hip ◽  
Hip Ultrasonography

Introduction The aim of this study was to define the clinical indications and demographic characteristics of patients undergoing open reduction for developmental dysplasia of the hip (DDH), and determine the proportion due to preventable failures of contemporary clinical screening and early management. Methods Case notes were reviewed of consecutive primary open reductions performed for non-teratologic hip dislocation at the Great Ormond Street Hospital for Children over a five-year period. Forty-eight patients (64 hips) were suitable for inclusion. A telephone survey confirmed selective hip ultrasonography screening protocols were employed in all maternity hospitals in our referral base. Results There were no cases of open reduction for unilateral DDH following Pavlik treatment commenced by six weeks of age, highlighting the importance of early detection and treatment. Eleven cases (23%) may have been avoided by appropriate implementation of existing selective ultrasonography screening protocols. Thirty-four cases (71%) presented after four months of age, suggesting open reduction is associated with late diagnosis rather than failure of primary management. None of these patients had neonatal hip ultrasonography and only 12% (4 patients) had a risk factor that should have triggered a scan. Conclusions Compared with published results, the contemporary screening practices in our referral base are failing to eliminate late presenting DDH and the need for open surgical reduction. Changes in strategy and implementation are required to significantly improve screening efficacy.

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 Total Hip Arthroplasty after Treatment of Pseudojoint Infection in a Patient with a Highly Dislocated Hip

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Kyung-Soon Park ◽  
Jong-Keun Seon ◽  
Seon-Yoon Nah ◽  
Taek-Rim Yoon
Keyword(s):  
Total Hip Arthroplasty ◽  
Infection Control ◽  
Hip Arthroplasty ◽  
English Literature ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Hip Pain ◽  
Total Hip ◽  
Thorough Debridement ◽  
Dysplasia Of The Hip

Infection at the pseudoacetabulum in a patient with a high hip dislocation has not been reported previously in the English literature. We report a case of total hip arthroplasty in a 28-year-old female who presented to us with hip pain following debridement of the infected pseudojoint in a case of neglected developmental dysplasia of the hip. The infection was treated with thorough debridement and drainage. However, even after achieving complete infection control, this patient complained of disabling right hip joint pain. Total hip arthroplasty with subtrochanteric osteotomy was performed to relieve the pain and improve gait. After surgery, the patient's symptoms were relieved. We consider that in this case of acute pseudojoint infection simple arthrotomy and debridement combined with irrigation and drainage provide effective treatment. But muscle weakness and more increased joint laxity can cause hip pain even after infection control. So total hip arthroplasty is likely to be necessary after the infection has been controlled in a patient with a highly dislocated hip.

scholarly journals Closed Reduction in Developmental Dysplasia of the Hip in Patients Older than One Year

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 276-281
Author(s):  
Zoran Bozinovski ◽  
Milena Bogojevska Doksevska ◽  
Keti P. Tokmakova
Keyword(s):  
Avascular Necrosis ◽  
Closed Reduction ◽  
Screening Method ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Range Of Movement ◽  
Cast Immobilization ◽  
Recommended Treatment ◽  
Dysplasia Of The Hip

Introduction: Besides an effective screening method for developmental dysplasia of the hip, there is certain number of children in whom the condition has been overseen or they have never been screened and the parents have noticed the odd walking pattern in their toddler. Treatment of such patients is controversial. One of the recommended treatment methods because of the short-term hospitalization, but often considered unsuccessful is closed reduction of the hip followed by cast immobilization. Hypothesis: Closed hip reduction in late diagnosed developmental dysplasia of the hip gives good results.  Aim: Our aim in this retrospective study was evaluation of the success of the treatment with closed reduction of hip dislocation in children older than 12 months.  Patients and methods: In the study, we included 20 patients treated at our clinic from June 2004 to May 2017. Of these 20 patients, 8 had bilateral involvement, 12 had unilateral, in a total of 28 hips. In all patients we noted preoperatively the range of movement, the presence of limp, any limb inequality, and hip pain. We used clinical and radiological parameters for evaluation. Clinically, we examined the range of movement, limb inequality as well as limb function and we classified it according to the modified McKay’s criteria. Same examinations were done at 1, 3, and 5 years after closed reduction. Results: At the last follow-up examination, using McKey’s criteria for clinical evaluation we rated the hips in two patients (7%) as grade III, i.e. fair grade, 10 hips (36%) were grade II – rated good, and 16 hips (57%) were evaluated as grade I. In four hips, there were signs of avascular necrosis of the hip, while in one patient the avascular necrosis developed after the closed reduction. Radiographic assessment (Figs 3, 4) using Severin’s scoring system showed no hips with types V and VI, type IV was observed in 7%, type III in 21%, type II in 29%, while most of the hips (12, 43%) were type I. Conclusion: We concluded that the procedure was justified. An advantage of this method is that it is inexpensive; it entails no direct operative changes of the bone structures and gives good results.

Developmental Dysplasia of the Hip

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 201-208
Author(s):  
David D. Aronsson ◽  
Michael J. Goldberg ◽  
Thomas F. Kling ◽  
Dennis R. Roy
Keyword(s):  
Early Detection ◽  
Physical Examination ◽  
Wide Spectrum ◽  
Developmental Dysplasia ◽  
Health Examination ◽  
Screening Examination ◽  
Neonatal Hip ◽  
Associated Risk Factors ◽  
Dysplasia Of The Hip ◽  
Pelvis Radiograph

Objective. The definition and early treatment of congenital dysplasia of the hip are controversial. The purpose of this study was to discuss the reasons for changing the acronym to developmental dysplasia of the hip (DDH) and to address its early detection and treatment. Design. This multicenter study was designed to provide an updated assessment of the definition, pathologic anatomy, prevalence, etiology, natural history, early detection, and treatment of DDH. Results. DDH more accurately describes the condition previously termed congenital dysplasia of the hip. The disorder is not always present at birth (congenital) and an infant may have a normal neonatal hip screening examination and subsequently develop a dysplastic or dislocated hip. Developmental dysplasia encompasses the wide spectrum of hip problems seen in infants and children. Physicians should understand that a normal neonatal screening examination does not assure normal hip development. The diagnosis of developmental dysplasia is made by physical examination. The Ortolani and Barlow maneuvers were designed to detect a subluxatable, dislocatable, or dislocated hip in the neonatal period. In the older child, limited abduction becomes a more reliable sign. The examination is variable depending on the type of dysplasia and changes with growth. The ultrasound is proving to be a sensitive tool in confirming the diagnosis in newborns and infants from birth to 4 months of age. The ultrasound is also valuable in older infants in terms of documenting that the dysplasia is responding to treatment. However, the ultrasound depends on an experienced sonographer and, in some cases, may be too sensitive, resulting in overtreatment. After 3 to 4 months of age, an anteroposterior pelvis radiograph can confirm the diagnosis. Conclusions. All newborns should have a neonatal hip screening physical examination. After screening, the hips should be re-examined during health examination visits at 2 weeks, 2 months, 4 months, 6 months, 9 months, and 1 year of age. If any question arises during these visits or if there are associated risk factors, we recommend an ultrasound if the infant is <4 months of age or an anteroposterior pelvis radiograph if >4 months of age.

scholarly journals Collagen I in the hip capsule plays a role in postoperative clinical function in patients with developmental dysplasia of the hip

2020 ◽  
Author(s):  
Bo Ning ◽  
Sicheng Zhang ◽  
Jun Sun
Keyword(s):  
Hip Dislocation ◽  
Pelvic Osteotomy ◽  
Developmental Dysplasia ◽  
Collagen I ◽  
Radiographic Outcomes ◽  
Imaging Results ◽  
Collagen Iii ◽  
Femoral Shortening ◽  
Hip Capsule ◽  
Dysplasia Of The Hip

Abstract Purpose The aims of the present study is to evaluate the roles of collagen I and III in the hip capsule in the postoperative clinical function of patients with developmental dysplasia of the hip (DDH). Methods Hip capsules from 155 hips of 120 patients were collected during surgery. The patients were divided into three groups according to age: I: 2–3.5 years; II: 3.5–5 years; and III: 5–6 years. Patient clinical function and radiographic outcomes were evaluated with the McKay scores and Severin classification. The expression of collagen I and III was detected through immunohistochemistry and quantitative reverse transcription polymerase chain reaction (RT-PCR) and analysed according to age, sex, degree of dislocation and McKay classification. All patients received open reduction and pelvic osteotomy and/or femoral shortening osteotomy and achieved good results on the basis of postoperative X-ray imaging. Results The average follow-up time was 3.4 years (range 2–4.3 years). There were no changes in the expression of collagen III in the different groups. The expression of collagen I according to age and sex was not significantly different. Lower expression of collagen I was observed in DDH patients with a higher degree of dislocation according to the Tonnis grade. The highest expression of collagen I was detected in the group with poor clinical function according to the McKay classification. Conclusion Collagen I is correlated with the degree of dislocation and is a risk factor for poor clinical function in DDH patients. Collagen I is correlated with the degree of hip dislocation and poor clinical function in DDH patients.

scholarly journals Collagen I in the hip capsule plays a role in postoperative clinical function in patients with developmental dysplasia of the hip

2020 ◽  
Author(s):  
Bo Ning ◽  
Sicheng Zhang ◽  
Jun Sun
Keyword(s):  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Collagen I ◽  
Radiographic Outcomes ◽  
X Ray Imaging ◽  
Imaging Results ◽  
Collagen Iii ◽  
Hip Capsule ◽  
Dysplasia Of The Hip

Abstract Purpose The aims of the present study is to evaluate the roles of collagen I and III in the hip capsule in the postoperative clinical function of patients with developmental dysplasia of the hip (DDH). Methods Hip capsules from 155 hips of 120 patients were collected during surgery. The patients were divided into three groups according to age: I: 2–3.5 years; II: 3.5–5 years; and III: 5–6 years. Patient clinical function and radiographic outcomes were evaluated with the McKay scores and Severin classification. The expression of collagen I and III was detected through immunohistochemistry and quantitative RT-PCR and analysed according to age, sex, degree of dislocation and McKay classification. All patients received similar operations and achieved good results on the basis of postoperative X-ray imaging. Results The average follow-up time was 3.4 years (range 2–4.3 years). There were no changes in the expression of collagen III in the different groups. The expression of collagen I according to age and sex was not significantly different. Lower expression of collagen I was observed in DDH patients with a higher degree of dislocation according to the Tonnis grade. The highest expression of collagen I was detected in the group with poor clinical function according to the McKay classification. Conclusion Collagen I is correlated with the degree of dislocation and is a risk factor for poor clinical function in DDH patients. Collagen I is correlated with the degree of hip dislocation and poor clinical function in DDH patients.

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