Developmental Dysplasia of the Hip(DDH) Flashcards
describe what DDH involves
dislocation or subluxation of the femoral head during the perinatal period which affect subsequent development of hip joint
what group of people does DDH usually affect
babies, females 8:1 males
what side is DDH more common in
left hip
what are the risk factors associated with DDH
FH, breech presentation, first born babies, down’s syndrome, the congenital diseases
what happens if DDH if left untreated
the acetabulum is very shallow, if severe false acetabulum occurs, severe arthritis can occur at early age
what are the clinical signs of DDH
shortening of lower limb, asymmetric groin/thick skin creases, click/clunk heard on Ortolani or Barlow manouvres
what does a positive Ortolani and Barlow test show
shows dislocated hip, unstable hip or shallow acetabulum
describe the Ortolani test for DDH
when you reduce a dislocated hip with abduction and anterior displacement
describe the Barlow test for DDH
dislocatable hip with flexion and posterior displacement
describe why X-rays are not effective investigation for early DDH
because femoral head epiphysis is unossified until around 4-6 months, only useful after this
what is the key to treatment of DDH
early diagnosis
how are mild cases of DDH slightly shallow acetabulum and mildly dislocatable but reduced hip managed
can be managed with serial examination and USS to ensure hip remains reduced
describe how are dislocated or persistently unstable hips in DDH treated
with Pavlik harness, which keeps hips in comfortable flexion and abduction thus maintaining reduction
how long does treatment with Pavlik harness usually last
used full-time for around 6 weeks and further 6 weeks part-time once hip is stable
what age can Pavlik harness be used for
4-6 months, has 85-95% success rate
