Developmental dysplasia of the hip Flashcards
what is Developmental dysplasia of the hip? (RF. Sx)
Spectrum of conditions affecting proximal femur and acetabulum - from subluxation to frank dislocation
true DDH - femoral head has abnoral bomy disability-premature arthritis and disability
RF - female (5x), breech presentation, 1st born, multiple pregn, oligohydramnios, high BW
Signs and Sx
Barlow and ortalani done at birth -
barlow -dislocate out of him
ortlani-relocate the hip back -if hear a click its positive
asymetrical skin fold,
Ling length discrepency (lay baby on back and extend knees)
later present -limp, abnromal gait, delayed walk/crawl, toe walk
Ix and mx of developemtal dysplasia of the hip
Neonatal screen -barlow and oralanis –if suspicious or +ve -USS
if baby born breech OR Fhx (1st degree) -USS
after 6m/o -xray is better at examining
mx
1st line in newborns -pavliks harness -keeps hips and knees abducted for several weeks
monitor sucess with USS/Xray
should resolve by 3-6weeks
2nd line (older pt)-surgery if conservative measure fail, or harness not helping
complications -avascular necrosis of the femoral head. temporary femoral nerve pasly
