DDH - pediatric Flashcards
Incidence of dysplasia:
1:100
Incidence of dislocation
1:1000
When does femoral head begin to ossify
4-6 months
- thefeore, get xrays beginning in this age group
When should ultrasound be done?
typically no earlier than 4-6 weeks of age
When should you abandon Pavlik harness?
if no reduction in 3-4 weeks
think similarly for abduction bracing
Age for closed reuction and spica casting?
6-18 months
When should you definitely consider osteotomy of femur/tab?
> 2 years with residual deformity do the femur
> 4 with acetabular deformity do the pelvis too
Possible blocks to closed reduction?
- iliopsoas contracture
- capsular constriction
- inverted labrum
- pulvinar
- hypertrophied ligamentum teres
Who gets a Dega?
neuromuscular hip patients with posterior acetabular deficiency
- needs open triradiate cartilage
- reduced acetabular volume
What is the radiographic acetabular teardrop?
- quadrilateral surface + cotyloid fossa
- should be present in normal hips by 18 mo
When are barlow/ortolani unreliable?
after 6 mo of age
Which acetabular osteotomy does not require a concentrically reduced hip?
Shelf procedure_ salvage procedure that covers a portion of the femoral head with capsule, hoping for capsular metaplasia. the hip may be subluxated.
Congenital muscular torticollis - associated conditions:
- DDH in 5-20%
- metatarsus adductus
DDx of congenital muscular torticollis
- congenital atlantoaxial rotatory instability
- klippel-feil syndrome
Grisel’s Disease
atlantoaxial rotatory subluxation following a URI
