Developmental Dysplasia of the Hip

Question 2

What percentage of newborns have developmental dysplasia of the hip?

Answer 2

1 in 500

Question 3

What are the risk factors for developmental dysplasia of the hip?

Answer 3

• family history
• female > male (5:1)
• breech birth
• large birth weight (>5kg)

Question 4

What are associations of developmental dysplasia of the hip?

Answer 4

• torticollis (20%)
• metatarsus adductus (10%)
• talipes calcaneovalgus
• Down’s syndrome.

Question 5

When are newborns screened for developmental dysplasia of the hip?

(at multiple points)

Answer 5

at the newborn exam (NIPE) and then at the six to eight week exam

Question 6

What are the physical examinations that can be used to diagnose developmental dysplasia of the hip?

Answer 6

Ortolani’s manoeuvre and Barlow’s manoeuvre

Question 7

How is Ortolani’s manoeuvre performed?

Answer 7

• Gentle pressure is used to abduct the hips
  
  • apply pressure behind the legs with the fingers to see if the hips will dislocate anteriorly.

https://youtube.com/clip/UgkxPPnfQK7SU5m43O8uKHPyfgeBkB_RN5Wk?feature=sh

Question 8

How is Barlow’s manoeuvre performed?

Answer 8

• Gentle downward pressure is placed on knees through femur
  to see if
• the femoral head will dislocate posteriorly.

https://youtube.com/clip/Ugkx8zfnuwMit9yTeIlxsExeiSB7Zranmt9H?feature=sh

Question 9

What is the first step in management pathway for developmental dysplasia of the hip?

Who do you refer to?

Answer 9

refer to your friendly, local paediatric orthopaedic surgeon

Question 10

What factor determines the specific management of developmental dysplasia of the hip?

Answer 10

age of diagnosis

Question 11

What is the first-line intervention for developmental dysplasia of the hip (before 8 weeks)?

Answer 11

Pavlik harness

Question 12

What is the first-line intervention for developmental dysplasia of the hip (before 8 weeks)?

Answer 12

surgical correction