Neonatal Hips Flashcards
What is the Galeazzi sign?
when legs are bent the knees aren’t the same height
What are some reasons you would scan a neonatal hip?
family history of DDH (developmental dysplasia of the hip)
breech presentation at birth (girls), oligohydramnios
abn findings on clinical exam
eval of infant with postural deformity
uneven gluteal crease
Hips wont abduct/adduct with _______
hip dislocation
At least ______of the femoral head should be covered
50%
slide13
what is the cartilage that looks like the ice cream cone on slide 13?
triradiate cartilage
in what directions does the hip dislocate?
superior and lateral
What maneuvers do the doctors do in order to determine DDH?
barlow
Ortolani
DDH ultrasounds can be done up to _______months of age
3
What angles do you need to use in order to measure the hip?
alpha angle
beta angle
What is the alpha angle?
between the baseline and acetabular roof
represents acetabular formation
normal is >60 degrees
see slide 20 for picture (line that goes through word labrum)
what is the beta angle
angle between the baseline and the inclination line (along labrum)
evaluates formation of cartilaginous acetabulum
normal 55 degrees
What is the Barlow Maneuver?
adduction (pushing inward) and gentle pushing against the knee with hip flexed (knees bent)
What is the Ortolani Maneuver?
Hip flexed and thigh abducted (pushed outward and down)
“clunk” is felt as femoral head returns to acetabulum
What are the anatomical parts of the hip?
ishium
ilium
femoral head
acetabular labrum
What is the neutral position?
leg extended
How many of Graf’s classification are there?
4
type 1 - normal alpha angle > 60*
type 2 - alpha angle 43-60*
type 3 - alpha angle 77*
type 4 - alpha angle <43* beta angle immeasurable
What is Graf’s type I?
normal
cannot be displaced out of acetabulum
can have up to 6mm of motion on left and 4mm on right
What is subluxable
femoral head displaced in relation to acetabulum
soft tissue echoes between femoral head and acetabulum
moves more than 6mm on Lt and 4mm on right
What does it mean for a hip to be dislocatABLE?
Can be displaced out of acetabulum but can be reduced
What does it mean for a hip to be dislocatED?
femoral head is displaced out of acetabulum and CANNOT be reduced
What are the secondary signs of DDH?
acetabular roof is irregular and angled
labrum echogenic and thickened
echogenic soft tissue between femoral head and bony acetabulum
acetabulum flattened
femoral head calcifies early
What is the treatment for DDH?
double diapering
spica cast
pavlik harness
What is a bachelor cast?
worn after spica cast removed
covers only the legs
child more flexible
can learn to walk while in cast
