Developmental dysplasia hips Flashcards
what
structural abnormality due to abnormal development during pregnancy
tendency/potential to sublux/disclocate
presentation
picked up newborn baby check
child with hip asymmetry, reduced ROM, limp
risk factors
1st degree FHx
breech presentation from 36wks onwards
breech presentation at delivery if 28+wks gestation
multiple pregnancy
screening
screened for at newborn baby check at birth and 6wks
newborn check - findings suggestive DDH
- different leg lengths
- restricted abduction
- difference knee levels when hips flexed
- clunking during special tests
special tests used to check for DDH
ortolani test
barlow test
ortolani test
palms on baby knee and thumbs inner thigh
gentle pressure abduct hips and pressure behind legs
see if hips dislocate anteriorly
barlow test
downward pressure femur to see if hips dislocate posteriorly
Ix
if suspected for DDH , USS if first line
referral protocol for USS screening
within 2-4wks if screening tests positive
within 4-6wks if screening negative but risk factor present
Mx
<6mo then pavlik harness
surgery if >6mo or harness fails
pavlik harness
holds femoral head in acetabulum to develop normal shape
keeps hips flexed and abducted
usually removed 6-8wks
