DEVELOPMENTAL DYSPLASIA OF THE HIP Flashcards
DDH definition
dislocation or subluxation of the head of the femur which causes subsequent changes in the developing hip joint
who mostly gets DDH
80% of cases affect girls
where does DDH have a predilection for
most commonly affects the left hip but can be bilateral
risk factors
female, first born, breech position, family history of DDH, downs syndrome, other disorder such as tallipes
presentation of DDH
asymmetrical length of legs (i.e. one is longer than the other), asymmetrical skin folds on inner thigh, inability to fully abduct the affected hip
examination
clunk heard on barlow or ortolani test
barlows test
the hip can be dislocated by applying a posterior abductor force
ortolanis test
the hip can be reduced by applying an anterior flexor force
investigations
ultrasound used for those under 6 months as x-rays are useless as the epiphyseal growth plate has not yet ossified, however, if over 6 months x-ray investigation of choice
management
if caught early enough child is put in a pavlik harness which is used full time for 6 weeks and part time for 6 weeks can be used up until 6 months and has 85% success rate, after this the child needs surgical reduction and the hip will never be norma
