Week 3 - Developmental Dysplasia of the Hip Flashcards

1
Q

what is DDH?

A

dislocation or subluxation of the femoral head during the perineal period which affects subsequent development of the hip joint

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2
Q

who/where does DDH commonly present?

A
girls
left hip (but can be bilateral)
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3
Q

what are the risk factors for DDH?

A
family history of DDH
breech presentation
first born babies
down syndrome
presence of other congenital disorders
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4
Q

what can happen if DDH is left untreated?

A

the acetabulum is very shallow or a false acetabulum occurs proximal to the original one with a shortened lower limb
severe arthritis at young age
gait/mobility can be severely affected

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5
Q

what are the signs of DDH?

A

shortening
asymmetric groin/thigh skin creases
click/clunk on ortolani or barlow manoeuvres

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6
Q

what is the ortolani manoeuvre?

A

reducing a dislocated hip with abduction and anterior displacement

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7
Q

what is the barlow manoeuvre?

A

dislocatable hip with flexion and posterior displacement

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8
Q

what is the next step is ortolani or barlow manoeuvre is positive?

A

US which should detect a dislocated hip, unstable hip or shallow acetabulum

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9
Q

are X rays used DHH?

A

not at early stage as the femoral head epiphysis is unossified until 4-6 months
X rays are first line after this age

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10
Q

how is mild DDH treated?

A

close observation with serial examination and ultrasound to ensure the hip remains reduced

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11
Q

how is more severe DDH treated?

A

dislocated hips are reduced and held with a special harness known as a Pavlik harness which keeps the hips in comfortable flexion and abduction, thus maintaining reduction

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12
Q

how are children with persistent dislocation over 18 months old managed?

A

open reduction is more likely to be required to clear soft tissues and may also need an osteotomy to shorten and rotate the femur and/or pelvic osteotomy to deepen and re-orientate the acetabulum

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