scholarly journals The predictive value of the clinical sign of excessive hip abduction for developmental dysplasia of the hip (DDH)

2018 ◽  
Vol 48 (1-2) ◽  
Author(s):  
Svemir Čustović ◽  
Kenan Čustović
Keyword(s):  
Clinical Sign ◽  
Predictive Value ◽  
Ultrasound Examination ◽  
Developmental Dysplasia ◽  
Gynecology And Obstetrics ◽  
Hip Abduction ◽  
Graf Method ◽  
The University ◽  
The Relationship ◽  
Dysplasia Of The Hip

Aim To assess the relationship between the clinical sign of excessive hip abduction (abduction of the hip 90 degrees or more) and developmental dysplasia of the hip (DDH). Methods The research was conducted on 450 newborns in the Neonatal Unit at the Clinic of Gynecology and Obstetrics and the Clinic of Orthopedics and Traumatology of the University Clinical Centre, Tuzla, between 30th August 2011 and 30th April 2012. Clinical (degree of hip abduction) and ultrasound examination of all newborns hip were performed using the Graf method on their first day of life. Results Clinical sign of excessive hip abduction showed significant predictive value for DDH. There were 37 (8.2%) newborns with the clinical sign of excessive hip abduction, of which 13 of them had DDH while 24 of them did not have this clinical sign. There were 89 newborns, in the overall sample, with one of the forms of DDH, 13 (12.7%) of them had this clinical sign, while from 324 newborns witouth DDH, 24 (6.9%) had this clinical sign. Excessive hip abduction had a positive predictive value (PPV) of 35.1% and a negative predictive value (NPV) of 78.5% for DDH. Conclusion Excessive hip abduction is an useful and important clinical sign of DDH. Doctors who perform the first examination of the child after birth, would have to turn their attention to this clinical sign. The newborns with this clinical sign would have to go to an ultrasound examination of the hips for further diagnosis.

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 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.

scholarly journals The positive predictive value of asymmetrical skin creases in the diagnosis of pathological developmental dysplasia of the hip

2018 ◽  
Vol 100-B (5) ◽  
pp. 675-679 ◽  
Author(s):  
M. J. Anderton ◽  
G. R. Hastie ◽  
R. W. Paton
Keyword(s):  
Risk Factors ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Clinical Signs ◽  
Senior Author ◽  
Developmental Dysplasia ◽  
Inclusion Criteria ◽  
Leg Length ◽  
One Stop ◽  
Dysplasia Of The Hip

Aims The aim of this study was to identify the association between asymmetrical skin creases of the thigh, buttock or inguinal region and pathological developmental dysplasia of the hip (DDH). Patients and Methods Between 1 January 1996 and 31 December 2016, all patients referred to our unit from primary or secondary care with risk factors for DDH were assessed in a “one stop” clinic. All had clinical and sonographic assessment by the senior author (RWP) with the results being recorded prospectively. The inclusion criteria for this study were babies and children referred with asymmetrical skin creases. Those with a neurological cause of DDH were excluded. The positive predictive value (PPV) for pathological DDH was calculated. Results A total of 105 patients met the inclusion criteria. There were 71 girls and 34 boys. Only two were found to have pathological DDH. Both also had unilateral limited abduction of the hip in flexion and a positive Galeazzi sign with apparent leg-length discrepancy. Thus, if the specialist examination of a patient with asymmetrical skin creases was normal, the PPV for DDH was 0%. Conclusion Isolated asymmetrical skin creases are an unreliable clinical sign in the diagnosis of pathological DDH. Greater emphasis should be placed on the presence of additional clinical signs to guide radiological screening in babies and children. Cite this article: Bone Joint J 2018;100-B:675–9.

scholarly journals Self-reported knowledge of national guidelines for clinical screening for hip dysplasia: a web-based survey of midwives and general practitioners in Denmark

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0068
Author(s):  
Hans-Christen Husum ◽  
Rikke Damkjær Maimburg ◽  
Søren Kold ◽  
Janus Laust Thomsen ◽  
Ole Rahbek
Keyword(s):  
General Practitioners ◽  
Correct Answer ◽  
Screening Program ◽  
Developmental Dysplasia ◽  
Further Education ◽  
Survey Study ◽  
National Guidelines ◽  
Web Based ◽  
Hip Abduction ◽  
Dysplasia Of The Hip

BackgroundThe positive predictive value of clinical hip examinations performed by generalist health professionals in screening for developmental dysplasia of the hip (DDH) is low.AimTo assess the self-reported recognition of nationally recommended clinical hip examinations in the screening programme for DDH in Denmark among midwives, general practitioners (GPs), and GPs in training.Design & settingA web based open survey study among Danish midwives, GPs and GPs in trainingMethodRespondents were asked to identify which of six written statements of clinical hip examinations were featured in the national Danish guidelines on DDH screening. Three statements were the official statements of the Ortolani, Galeazzi, and hip abduction examinations from the national guidelines and three statements were false and constructed by the author group. Participants were asked to select up to six statements.ResultsA total of 178 (58 GPs, 97 midwives and 23 GPs in training) responses were included.Eighty-nine per cent of responders correctly identified the Ortolani manoeuvre and 92% correctly identified one of the constructed descriptions as being false. The remaining four descriptions had significantly lower correct answer percentages ranging from 41% to 58% with significantly lower correct answer percentages of midwives for three out of all six descriptions when compared to GPs.ConclusionWe conclude that the recognition of two out of three recommended clinical hip examinations in the Danish screening program for DDH is overall low among current screeners. Efforts should be made to heighten the knowledge level by further education of screeners.

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