Developmental Dysplasia of the Hip

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

31

Pages:

3
Author:

Kyuwon J.

DDH ● Not a single abnormality but a spectrum ○ abnormality. In hip joint developments ○ Mild acetabular dysplasia(moderately mild) ○ complete dislocation of femoral head (severe) ■ displaced from acetabulum ● condition present on birth ○ could also become present during developmental period in infancy Normal hip dev ● Main stability of hip joints ○ acetabular dept appropriate ○ spherical femoral heads ○ joint and ligament capsule tight ● in normal ceases, it requires concentric reduction ● failure for interaction means dysplasia Epidemiology ● ~1-2 in 1000 births ● Rx ○ females are 4-6 times more vulnerable compared to male babies ■ estrogen-mediated ligament laxity ○ first born infants ○ left hip ■ most common ○ Mechanical factors ■ breech presentation ● frank breech ■ Oligohydramnios ■ Tight swaddling ● once hip is extended ○ Maternal factors ■ FHx ○ Associated conditions ■ Torticollis ■ Metatarsus adductus ■ Neuromuscular disorder Pathophysiology ● Ligamentous laxity ○ femoral head instability ● abnormal contact ○ femoral head/acetabulum ● acetabulum shallow, does not go deeper ● displacement worsens Clinical Examinations ● Newborn screening test ○ Ortolani test ■ detection on dislocated reducible hips ■ palpable clunk ● because femoral head will reduce into acetabulum ○ Barlow tests ■ unstable hip detections ■ Positive femoral head will be dislocated posteriorly ● older infants / Child ○ limitation on hip abductions ○ limb length discrepancy ■ Galeazzi signs ○ Delaying walking ○ bilateral DDH ○ trendelenburg gait DDH tends to be developmental and progressive therefore early detection is crucial for new born babies . Must provide age appropriate physical exam + scheduled imaging Mx depends on age of diagnosis not the severity(has little to do with it but is not the main reason)