Developmental Hip Dysplasia

Question 1

Definition

Answer 1

broad spectrum of hip anomalies in infants and young children, resulting from abnormal growth and development of the hip joint
head of femur dislocated from the hip joint
results in abnormal weight bearing forces, doesn’t grow correctly

Question 2

Risk Factors

Answer 2

Utero

• malpositioning breech
• oligohydramnios
• overdue by 2 wks
• female
• family history
• carrying and positioning in hip adduction and extension

Associated with torticollis, foot deformity, arthrogyposis

Question 3

Carrying and Positioning

Answer 3

want to avoid extension, and adduction
- don’t use slings/carriers
Want to promote flexion and abduction

Question 4

Long term outcomes

Answer 4

Requires early intervention

later diagnosis = more likely to need surgery

Question 5

Assessment

Answer 5

Galeazzi - unequal leg length in 90 degrees hip flexion
Reduced ROM hip abduction
asymmetrical hip abduction in flexion
asymmetry in the glute/thigh rolls
Barlow Manouevre - hip is dislocatable
Ortolani Manouevre - attempts to relocate dislocated hip
- done by paediatricians

Question 6

Management

Answer 6

older = more likely to need surgery
less than 6 mths = use harness to correct positioning
- educate parents on correct handling
if have surgery - need appropriate prehab and rehab