Developmental dysplasia of the hip (DDH) is a spectrum of hip abnormalities that develop prenatally or in infancy. Risk factors include female gender, first born status, breech positioning, and family history. Diagnosis involves physical exam maneuvers like the Ortolani and Barlow tests as well as ultrasound or radiography. Treatment depends on age and severity, ranging from Pavlik harness for mild cases to closed or open reduction and casting for more severe cases. Surgical treatment aims to reduce the hip in a concentric and stable position but carries risks of osteonecrosis, nerve injury, and failure of reduction.
This document summarizes various investigative techniques and treatments for developmental dysplasia of the hip (DDH). It discusses ultrasound, radiography, and other imaging modalities used to classify DDH severity. Treatment approaches are divided by age group, including using Pavlik harness for newborns, closed/open reduction and casting for infants, and surgery for older children if needed. The goal is to gently reduce the hip and maintain stability in a safe range of motion to prevent osteonecrosis of the femoral head.
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders involving abnormal development of the femoral head and acetabulum. It ranges from instability where the femoral head can subluxate to full dislocation. Risk factors include ligamentous laxity and breech positioning. Ultrasound and x-rays are used to diagnose and monitor treatment, which may involve closed or open reduction depending on age, along with bracing or casting. The goal is early concentric reduction to prevent future hip degeneration.
Prof. Anis Bhatti lecture on DDH evaluation & screening ProtocolsAnisuddin Bhatti
Prof. Anisuddin Bhatti, Paediatric Orthopaedic Surgeon, Dr. Ziauddin University Hospital Clifton Karachi, presented webinar on Developmental dysplastic hip, series 1. on <meet.google.com> on 16.10.2020. Presentation mostly for trainees & jr. consultants. He explained in detail, pathoanatomy, screening protocols, ultrasonography & radiological evaluation of DDH cases.
Developmental dysplasia of the hip (DDH) is a condition where the femoral head has an abnormal relationship with the acetabulum. It includes hip dysplasia or dislocation that develops after birth. Risk factors include breech presentation and family history. Screening involves clinical examination of neonates and ultrasound if risk factors present. Treatment depends on age and ranges from Pavlik harness or casting for neonates to closed or open reduction and femoral shortening or acetabular reorientation procedures for older children. Management of adult DDH involves restoration of the hip center and correction of bony deformities during total hip replacement.
Developmental dysplasia of the hip (DDH) is a spectrum disorder ranging from mild dysplasia to frank dislocation of the hip. Risk factors include female sex, first born children, family history, and breech positioning. Diagnosis involves a thorough physical exam including Ortolani's and Barlow's maneuvers and may include imaging like x-rays and ultrasound. Treatment depends on age and severity, ranging from harness or casting for younger infants to closed or open reduction and casting/bracing for older infants and children. Complications can include avascular necrosis if reduction is not performed carefully.
Developmental dysplasia of the hip (DDH) is a condition where the femoral head has an abnormal relationship with the acetabulum. The document discusses the normal development of the hip joint, pathoanatomy and clinical presentation of DDH, as well as methods of diagnosis including imaging and treatment options depending on the age of presentation. Treatment in infants less than 6 months involves the Pavlik harness to obtain and maintain reduction of the hip to allow for normal development.
This document discusses developmental dysplasia of the hip (DDH), including its etiology, presentation, diagnosis and treatment. Key points include:
- DDH is a spectrum of hip disorders presenting at different ages, including subluxation, acetabular dysplasia and dislocation.
- Risk factors include ligamentous laxity, breech positioning, and postnatal positioning with hips in extension.
- Clinical diagnosis involves the Ortolani and Barlow tests for instability in infants. Imaging includes ultrasound and x-rays.
- Left untreated, DDH can progress from instability to dislocation and eventual osteoarthritis. Treatment aims to prevent this progression.
This document summarizes various investigative techniques and treatments for developmental dysplasia of the hip (DDH). It discusses ultrasound, radiography, and other imaging modalities used to classify DDH severity. Treatment approaches are divided by age group, including using Pavlik harness for newborns, closed/open reduction and casting for infants, and surgery for older children if needed. The goal is to gently reduce the hip and maintain stability in a safe range of motion to prevent osteonecrosis of the femoral head.
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders involving abnormal development of the femoral head and acetabulum. It ranges from instability where the femoral head can subluxate to full dislocation. Risk factors include ligamentous laxity and breech positioning. Ultrasound and x-rays are used to diagnose and monitor treatment, which may involve closed or open reduction depending on age, along with bracing or casting. The goal is early concentric reduction to prevent future hip degeneration.
Prof. Anis Bhatti lecture on DDH evaluation & screening ProtocolsAnisuddin Bhatti
Prof. Anisuddin Bhatti, Paediatric Orthopaedic Surgeon, Dr. Ziauddin University Hospital Clifton Karachi, presented webinar on Developmental dysplastic hip, series 1. on <meet.google.com> on 16.10.2020. Presentation mostly for trainees & jr. consultants. He explained in detail, pathoanatomy, screening protocols, ultrasonography & radiological evaluation of DDH cases.
Developmental dysplasia of the hip (DDH) is a condition where the femoral head has an abnormal relationship with the acetabulum. It includes hip dysplasia or dislocation that develops after birth. Risk factors include breech presentation and family history. Screening involves clinical examination of neonates and ultrasound if risk factors present. Treatment depends on age and ranges from Pavlik harness or casting for neonates to closed or open reduction and femoral shortening or acetabular reorientation procedures for older children. Management of adult DDH involves restoration of the hip center and correction of bony deformities during total hip replacement.
Developmental dysplasia of the hip (DDH) is a spectrum disorder ranging from mild dysplasia to frank dislocation of the hip. Risk factors include female sex, first born children, family history, and breech positioning. Diagnosis involves a thorough physical exam including Ortolani's and Barlow's maneuvers and may include imaging like x-rays and ultrasound. Treatment depends on age and severity, ranging from harness or casting for younger infants to closed or open reduction and casting/bracing for older infants and children. Complications can include avascular necrosis if reduction is not performed carefully.
Developmental dysplasia of the hip (DDH) is a condition where the femoral head has an abnormal relationship with the acetabulum. The document discusses the normal development of the hip joint, pathoanatomy and clinical presentation of DDH, as well as methods of diagnosis including imaging and treatment options depending on the age of presentation. Treatment in infants less than 6 months involves the Pavlik harness to obtain and maintain reduction of the hip to allow for normal development.
This document discusses developmental dysplasia of the hip (DDH), including its etiology, presentation, diagnosis and treatment. Key points include:
- DDH is a spectrum of hip disorders presenting at different ages, including subluxation, acetabular dysplasia and dislocation.
- Risk factors include ligamentous laxity, breech positioning, and postnatal positioning with hips in extension.
- Clinical diagnosis involves the Ortolani and Barlow tests for instability in infants. Imaging includes ultrasound and x-rays.
- Left untreated, DDH can progress from instability to dislocation and eventual osteoarthritis. Treatment aims to prevent this progression.
Developmental dysplasia of the hip (DDH) is a condition where the hip joint is not properly formed or does not properly develop during fetal life or infancy. It ranges from shallow hip sockets to partial or complete dislocation of the hip joint. The goals of treatment are to reduce the femoral head into the acetabulum and maintain a concentric reduction to allow for normal hip development. Treatment depends on the age of presentation and severity, and may include use of a Pavlik harness, hip spica cast, closed or open surgical reduction, and osteotomies. Early diagnosis and treatment generally lead to better outcomes.
This document discusses developmental dysplasia of the hip (DDH). It describes the signs and symptoms, risk factors, diagnosis, and treatment approaches for different age groups. For newborns under 6 months, treatment focuses on stabilization or reduction of the hip using the Pavlik harness. For infants 6-18 months, closed or open reduction is often needed if the hip is dislocated due to soft tissue contractures. Preliminary traction may help reduce risks of osteonecrosis during reduction in this age group.
This document provides an overview of developmental dysplasia of the hip (DDH), including its normal development, etiology, epidemiology, diagnosis, treatment, and complications. Key points include: DDH can range from mild dysplasia to frank dislocation and is more common in females. Clinical diagnosis involves the Ortolani and Barlow maneuvers while imaging includes x-rays and ultrasound. Treatment depends on the grade of DDH and may involve closed or open reduction along with bracing or splinting. Complications can include avascular necrosis and osteoarthritis if left untreated.
This document discusses developmental dysplasia of the hip (DDH), including its pathogenesis, clinical features at different ages, diagnostic imaging tools, and management approaches. DDH is a spectrum of hip disorders that can present from birth through childhood. Management involves both non-surgical and surgical techniques depending on the age of presentation and severity, with the goal of achieving and maintaining a stable, concentric reduction to allow normal hip development. Surgical options range from closed or open reduction to osteotomies to improve acetabular coverage. Careful long-term follow up is important to monitor for residual dysplasia or deformity.
This document provides information on various types of splints used to treat developmental dysplasia of the hip (DDH), including:
- The Pavlik harness, which places hips in flexion and allows abduction, with indications for its use in neonates and infants up to 1 year old.
- The Ilfeld/Craig splint, which positions hips in abduction and external rotation.
- The Frejka pillow and triple diapers, which are no longer recommended due to risk of avascular necrosis.
- The von Rosen splint, which positions hips in 90 degrees flexion and 60-70 abduction with a reported 95% success rate and low risk of complications.
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders that can occur from conception to skeletal maturity. It most commonly affects females and risk factors include genetic predisposition, breech positioning, and hormonal influences. Clinical features include limb asymmetry and limited hip movement. Diagnosis involves clinical tests and imaging like ultrasound or X-rays. Management depends on age, with splinting often used for young infants and closed or open reduction with spica casting for older children. Complications can include limping, osteoarthritis, or avascular necrosis if left untreated.
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders that can include dislocation, subluxation, or dysplasia. It was previously known as congenital hip dislocation. Risk factors include breech presentation, family history, ligament laxity, female sex, and nursing position. Clinical diagnosis involves the Ortolani and Barlow tests. Ultrasound screening can identify dysplastic or dislocated hips and monitor treatment. Treatment for infants under 6 months aims to reduce the femoral head using a Pavlik harness to stimulate acetabular development. Without treatment, instability often leads to degenerative joint disease in adulthood.
This document discusses developmental dysplasia of the hip (DDH), which refers to dysplasia of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to complete hip dislocation. DDH is more common in females and risk factors include breech presentation and family history. Treatment depends on age, with Pavlik harness used in infants under 6 months and hip spica casting for older infants and children under 2 years. The goal of treatment is to reduce the femoral head in the acetabulum and allow normal hip joint development.
This document discusses developmental dysplasia of the hip (DDH), also known as congenital hip dysplasia. DDH ranges from shallow acetabulum to complete hip dislocation. Risk factors include breech presentation and family history. Diagnosis involves clinical tests like Barlow and Ortolani in newborns and ultrasound or x-ray in older infants. Treatment depends on age and includes Pavlik harness in newborns, closed or open reduction and casting in infants, and osteotomies if needed in older children. Complications can include avascular necrosis. Proper screening and treatment can prevent long term issues from untreated DDH.
Developmental dysplasia of the hip (DDH) is a spectrum of displacement of the femoral head from the acetabulum that can occur before, during, or after birth. It ranges from dysplasia to subluxation to frank dislocation. Risk factors include female sex, first born, family history, and breech position. Ultrasound and x-rays are used to classify the condition and guide management, which may include harness, closed reduction, or open reduction depending on the age of presentation and severity. The goal is to achieve a stable reduction and allow normal hip development.
Developmental dysplasia of the hip (DDH) refers to abnormal development of the hip joint during infancy. It ranges from mild hip instability to complete dislocation. Risk factors include breech positioning, family history, and neuromuscular disorders. Diagnosis is made through clinical examination and imaging studies like ultrasound and x-rays. Treatment depends on the severity and may include closed or open reduction and casting or bracing. Complications can include degenerative joint disease, leg length discrepancy, and back pain if left untreated.
This document discusses congenital dislocation of the hip. It defines developmental dysplasia of the hip as partial or complete displacement of the femoral head from the acetabulum present since birth. Risk factors include being female, a first born, having a family history, or experiencing faulty intrauterine positioning such as breech presentation. Diagnosis involves physical exam findings like leg length discrepancy and a positive Ortolani or Barlow maneuver. Treatment depends on age and may involve closed or open reduction along with hip spica casting or surgical procedures like femoral and pelvic osteotomies.
Developmental dysplasia of the hip is a condition where the hip joint fails to form properly. It ranges from mild dysplasia to frank dislocation. The best outcomes are seen when treated before 6 months of age using a Pavlik harness. Between 6-18 months, closed or open reduction with spica casting is used. For older children, closed or open reduction with or without pelvic osteotomy is required. Complications include avascular necrosis, redislocation, and residual dysplasia if left untreated. Early diagnosis and treatment leads to the best long-term outcomes.
Ultrasonic evaluation of developmental dysplasia of the hip (DDH) involves two key assessments: I) morphology assessment using Graf angles to evaluate acetabular shape and II) stability assessment using a dynamic examination to evaluate hip movement and subluxation under stress. Performing the examination properly requires obtaining specific sonographic views of the hip anatomy and applying stress in flexion positions to fully assess morphology and instability.
Management of Develpmental Dysplasia of the HipDrkabiru2012
Developmental dysplasia of the hip (DDH) is a spectrum of hip pathology ranging from instability to dislocation that is present at or shortly after birth. DDH has an incidence of 1 in 1000 live births and is more common in females. Risk factors include breech presentation and a family history. Pathological changes in DDH progress from instability to deformity of the hip joint as the child grows. Treatment ranges from observation to bracing to closed or open reduction depending on the severity. Early identification and treatment lead to the best outcomes, while late or untreated cases can result in residual dysplasia or hip degeneration.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical tests and ultrasound imaging to detect abnormalities.
3. Treatment depends on age and severity but generally aims to reduce the femoral head and maintain the reduction through devices like Pavlik harness or hip spica casting. Surgical intervention may be needed for older patients or failed non-surgical treatment.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
Developmental dysplasia of the hip (DDH) is a condition where the hip joint is not properly formed or does not properly develop during fetal life or infancy. It ranges from shallow hip sockets to partial or complete dislocation of the hip joint. The goals of treatment are to reduce the femoral head into the acetabulum and maintain a concentric reduction to allow for normal hip development. Treatment depends on the age of presentation and severity, and may include use of a Pavlik harness, hip spica cast, closed or open surgical reduction, and osteotomies. Early diagnosis and treatment generally lead to better outcomes.
This document discusses developmental dysplasia of the hip (DDH). It describes the signs and symptoms, risk factors, diagnosis, and treatment approaches for different age groups. For newborns under 6 months, treatment focuses on stabilization or reduction of the hip using the Pavlik harness. For infants 6-18 months, closed or open reduction is often needed if the hip is dislocated due to soft tissue contractures. Preliminary traction may help reduce risks of osteonecrosis during reduction in this age group.
This document provides an overview of developmental dysplasia of the hip (DDH), including its normal development, etiology, epidemiology, diagnosis, treatment, and complications. Key points include: DDH can range from mild dysplasia to frank dislocation and is more common in females. Clinical diagnosis involves the Ortolani and Barlow maneuvers while imaging includes x-rays and ultrasound. Treatment depends on the grade of DDH and may involve closed or open reduction along with bracing or splinting. Complications can include avascular necrosis and osteoarthritis if left untreated.
This document discusses developmental dysplasia of the hip (DDH), including its pathogenesis, clinical features at different ages, diagnostic imaging tools, and management approaches. DDH is a spectrum of hip disorders that can present from birth through childhood. Management involves both non-surgical and surgical techniques depending on the age of presentation and severity, with the goal of achieving and maintaining a stable, concentric reduction to allow normal hip development. Surgical options range from closed or open reduction to osteotomies to improve acetabular coverage. Careful long-term follow up is important to monitor for residual dysplasia or deformity.
This document provides information on various types of splints used to treat developmental dysplasia of the hip (DDH), including:
- The Pavlik harness, which places hips in flexion and allows abduction, with indications for its use in neonates and infants up to 1 year old.
- The Ilfeld/Craig splint, which positions hips in abduction and external rotation.
- The Frejka pillow and triple diapers, which are no longer recommended due to risk of avascular necrosis.
- The von Rosen splint, which positions hips in 90 degrees flexion and 60-70 abduction with a reported 95% success rate and low risk of complications.
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders that can occur from conception to skeletal maturity. It most commonly affects females and risk factors include genetic predisposition, breech positioning, and hormonal influences. Clinical features include limb asymmetry and limited hip movement. Diagnosis involves clinical tests and imaging like ultrasound or X-rays. Management depends on age, with splinting often used for young infants and closed or open reduction with spica casting for older children. Complications can include limping, osteoarthritis, or avascular necrosis if left untreated.
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders that can include dislocation, subluxation, or dysplasia. It was previously known as congenital hip dislocation. Risk factors include breech presentation, family history, ligament laxity, female sex, and nursing position. Clinical diagnosis involves the Ortolani and Barlow tests. Ultrasound screening can identify dysplastic or dislocated hips and monitor treatment. Treatment for infants under 6 months aims to reduce the femoral head using a Pavlik harness to stimulate acetabular development. Without treatment, instability often leads to degenerative joint disease in adulthood.
This document discusses developmental dysplasia of the hip (DDH), which refers to dysplasia of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to complete hip dislocation. DDH is more common in females and risk factors include breech presentation and family history. Treatment depends on age, with Pavlik harness used in infants under 6 months and hip spica casting for older infants and children under 2 years. The goal of treatment is to reduce the femoral head in the acetabulum and allow normal hip joint development.
This document discusses developmental dysplasia of the hip (DDH), also known as congenital hip dysplasia. DDH ranges from shallow acetabulum to complete hip dislocation. Risk factors include breech presentation and family history. Diagnosis involves clinical tests like Barlow and Ortolani in newborns and ultrasound or x-ray in older infants. Treatment depends on age and includes Pavlik harness in newborns, closed or open reduction and casting in infants, and osteotomies if needed in older children. Complications can include avascular necrosis. Proper screening and treatment can prevent long term issues from untreated DDH.
Developmental dysplasia of the hip (DDH) is a spectrum of displacement of the femoral head from the acetabulum that can occur before, during, or after birth. It ranges from dysplasia to subluxation to frank dislocation. Risk factors include female sex, first born, family history, and breech position. Ultrasound and x-rays are used to classify the condition and guide management, which may include harness, closed reduction, or open reduction depending on the age of presentation and severity. The goal is to achieve a stable reduction and allow normal hip development.
Developmental dysplasia of the hip (DDH) refers to abnormal development of the hip joint during infancy. It ranges from mild hip instability to complete dislocation. Risk factors include breech positioning, family history, and neuromuscular disorders. Diagnosis is made through clinical examination and imaging studies like ultrasound and x-rays. Treatment depends on the severity and may include closed or open reduction and casting or bracing. Complications can include degenerative joint disease, leg length discrepancy, and back pain if left untreated.
This document discusses congenital dislocation of the hip. It defines developmental dysplasia of the hip as partial or complete displacement of the femoral head from the acetabulum present since birth. Risk factors include being female, a first born, having a family history, or experiencing faulty intrauterine positioning such as breech presentation. Diagnosis involves physical exam findings like leg length discrepancy and a positive Ortolani or Barlow maneuver. Treatment depends on age and may involve closed or open reduction along with hip spica casting or surgical procedures like femoral and pelvic osteotomies.
Developmental dysplasia of the hip is a condition where the hip joint fails to form properly. It ranges from mild dysplasia to frank dislocation. The best outcomes are seen when treated before 6 months of age using a Pavlik harness. Between 6-18 months, closed or open reduction with spica casting is used. For older children, closed or open reduction with or without pelvic osteotomy is required. Complications include avascular necrosis, redislocation, and residual dysplasia if left untreated. Early diagnosis and treatment leads to the best long-term outcomes.
Ultrasonic evaluation of developmental dysplasia of the hip (DDH) involves two key assessments: I) morphology assessment using Graf angles to evaluate acetabular shape and II) stability assessment using a dynamic examination to evaluate hip movement and subluxation under stress. Performing the examination properly requires obtaining specific sonographic views of the hip anatomy and applying stress in flexion positions to fully assess morphology and instability.
Management of Develpmental Dysplasia of the HipDrkabiru2012
Developmental dysplasia of the hip (DDH) is a spectrum of hip pathology ranging from instability to dislocation that is present at or shortly after birth. DDH has an incidence of 1 in 1000 live births and is more common in females. Risk factors include breech presentation and a family history. Pathological changes in DDH progress from instability to deformity of the hip joint as the child grows. Treatment ranges from observation to bracing to closed or open reduction depending on the severity. Early identification and treatment lead to the best outcomes, while late or untreated cases can result in residual dysplasia or hip degeneration.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical tests and ultrasound imaging to detect abnormalities.
3. Treatment depends on age and severity but generally aims to reduce the femoral head and maintain the reduction through devices like Pavlik harness or hip spica casting. Surgical intervention may be needed for older patients or failed non-surgical treatment.
1. Developmental dysplasia of the hip (DDH) refers to dysplasia or dislocation of the hip joint that develops during fetal life or infancy. It can range from shallow acetabulum to partial or complete dislocation.
2. Risk factors include female sex, breech presentation, family history, and swaddling practices that restrict hip movement. Screening involves clinical examination and ultrasound of newborns and infants.
3. Treatment depends on age and severity but aims to reduce the femoral head and maintain the reduction to allow for normal hip development. Options include Pavlik harness, hip spica casting, and surgery.
This document discusses developmental dysplasia of the hip (DDH), including its causes, types, diagnosis, and treatment approaches. DDH encompasses a spectrum of hip abnormalities from instability to dislocation. It can be syndromic, associated with other conditions, or non-syndromic. Diagnosis involves physical exams and ultrasound to assess hip stability and anatomy. Treatment depends on age and severity, ranging from harnessing like Pavlik to manage instability, to closed or open reduction surgery for older children with dislocation. The goal is stable, concentric reduction and correction of any acetabular dysplasia.
This document discusses developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip. DDH is a spectrum of pathology in the development of the immature hip joint, ranging from mild dysplasia to frank dislocation. Risk factors include increased joint laxity, female sex, breech presentation, tight intrauterine space, and family history. Diagnosis involves physical examination maneuvers in infants and imaging like ultrasound and x-rays in older children. Treatment depends on age, with harnesses and casting for young infants and open reduction and casting for older children. Complications can include avascular necrosis, redislocation, and residual deformities.
Developmental Dysplasia of Hip final.pptxsudarshan731
This document provides information on Developmental Dysplasia of the Hip (DDH), including its definition, risk factors, diagnosis, and management approaches. DDH is a spectrum of abnormalities where the hip joint does not properly form during development before or after birth. Risk factors include breech positioning and female sex. Diagnosis involves clinical examination and imaging like ultrasound and x-rays. Management is based on age and severity, ranging from harness treatment in infants, to closed or open reduction and casting in older children, and osteotomies or salvage procedures in older children and adults. The goal is early diagnosis and treatment to reduce dislocation and prevent complications like avascular necrosis.
Developmental dysplasia of the hip (DDH) is a condition where the hip joint is not properly formed or does not properly develop during fetal life or infancy. It ranges from shallow hip sockets to partial or complete dislocation of the hip joint. The goals of treatment are to reduce the femoral head into the acetabulum and maintain a concentric reduction to allow for normal hip development. Treatment depends on the age of presentation and severity, and may include use of a Pavlik harness, hip spica cast, closed or open surgical reduction, and osteotomies. Early diagnosis and treatment generally lead to better outcomes.
Developmental dysplasia of the hip (DDH) is a spectrum of abnormalities including hip dysplasia, subluxation, and dislocation caused by capsular laxity and mechanical factors during development. DDH is most common in females and the left hip. Risk factors include being firstborn, breech position, and family history. Presentation depends on age, ranging from asymptomatic in newborns to Trendelenburg gait in older children. Treatment options include non-operative methods like Pavlik harness for infants or closed reduction and spica casting for older infants, and operative methods like open reduction and osteotomies for older children with residual dysplasia.
This document discusses developmental dysplasia of the hip (DDH). It begins by defining DDH and providing epidemiological data on incidence. It then covers normal hip development, risk factors, clinical presentation, imaging findings, and management approaches. For newborns, treatment focuses on stabilizing unstable hips or reducing dislocated hips using a Pavlik harness, which places the hips in flexion and abduction. The success rate of the Pavlik harness in newborns is reported to be 85-95%.
Developmental dysplasia of the hip (DDH) is a spectrum of abnormalities in hip development ranging from mild acetabular dysplasia to dislocated hips. Girls are affected six times more often than boys, and in one third of cases both hips are affected. Abnormalities may not be noticed until the child begins to walk and presents with a limp or waddling gait. Diagnosis involves clinical examination and ultrasound or X-ray imaging to assess hip stability and anatomy. Treatment depends on age and severity, ranging from splinting in flexion and abduction for mild cases to closed or open reduction and hip immobilization in a spica cast for more severe or persistent dislocations.
Developmental dysplasia of the hip (DDH) refers to hip dislocation, subluxation, instability or dysplasia. It has an incidence of 0.7-35 per 1000 live births. Risk factors include female sex, breech presentation, and family history. Neonates are clinically examined and those with persistent hip clicks undergo ultrasound at 6 weeks and x-rays at 3 months. The Pavlik harness is used for babies 3-9 months old to reduce dislocated hips. Traction and closed or open reduction are used from 6 months to 2 years if needed. X-rays evaluate alignment, and ultrasound and arthrograms help assess reduction. Complications include avascular necrosis, which is related to treatment
This document discusses idiopathic scoliosis, specifically infantile, juvenile, and adolescent types. It defines scoliosis as a lateral curvature of the spine with associated vertebral rotation. Infantile scoliosis occurs in children under 3 years old and can be progressive, requiring casting or bracing. Juvenile scoliosis appears from ages 4-10 and is typically treated with bracing. Adolescent scoliosis develops after age 10 and has the highest risk of progression during growth spurts, sometimes necessitating surgery to prevent deformity. The document outlines approaches for classifying, evaluating, and treating different forms of idiopathic scoliosis at various stages of development.
Hypospadias is a congenital anomaly where the opening of the urethra is on the ventral side of the penis rather than at the tip. It occurs in about 1 in 250 male newborns. The document discusses the definition, causes, classification, diagnosis, and surgical techniques for repairing hypospadias. Surgical repair aims to correct penile curvature if present and create a functional urethra in a cosmetically normal position. Complications can include bleeding, meatal stenosis, and impaired healing but early repair from ages 6-12 months has better outcomes.
This document summarizes three pediatric knee conditions:
1) Congenital dislocation of the knee joint, which presents at birth with hyperextension and can be treated non-operatively with casting or operatively with soft tissue releases.
2) Congenital dislocation of the patella, which is a lateral dislocation present at birth that can be treated with the Andrish surgical technique involving extensive soft tissue releases.
3) Bipartate patella, a normal variant where the patella fails to fuse during development, which is usually asymptomatic but can become painful and be treated initially with rest and physical therapy or later with fragment excision.
This document discusses developmental dysplasia of the hip (DDH), including its definition, incidence, causes, clinical tests for diagnosis, imaging techniques, and management approaches. DDH results from abnormal development of the hip joint and can range from instability to complete dislocation. Risk factors include female sex, breech positioning, and family history. Clinical exams include the Ortolani and Barlow tests. Ultrasound and x-rays are used for imaging. Treatment depends on age and severity, and may involve harnessing, casting, or surgery to achieve a concentric reduction without tension. The goal is normal development through positioning the femoral head in the acetabulum.
Hypospadias is a congenital defect where the opening of the urethra is on the ventral side of the penis rather than at the tip. It occurs in about 1 in 250 male newborns and is thought to result from arrested penile development leaving a proximal urethral opening. Treatment involves surgical repair to reposition the urethra, which depends on the location and severity of the hypospadias but generally aims to maximize function and cosmetic appearance. Complications can include bleeding, meatal stenosis and fistula formation.
This document provides information on developmental dysplasia of the hip (DDH). It discusses the definition, causes, incidence, clinical findings, pathology, diagnosis through imaging like ultrasound and X-rays, and treatment approaches for different age groups from newborns to older children. Key tests like Barlow, Ortolani and imaging classifications including Graf are outlined. The main treatment mentioned is use of Pavlik harness for young infants, while older infants may require traction and closed reduction or open reduction if closed fails.
This document provides an outline and overview of developmental dysplasia of the hip (DDH). It discusses the epidemiology, relevant anatomy, etiology, pathology, clinical presentation, investigations, classification, treatment, complications and follow-up of DDH. The key points are that DDH is a spectrum of developmental disorders of the hip including acetabular dysplasia, subluxation and dislocation. Treatment depends on the age of presentation and degree of instability, and may include splinting, closed or open reduction, and osteotomies. Complications can include avascular necrosis, failure of reduction, and damage to surrounding structures.
Hypospadias is a congenital anomaly where the urethral opening is on the underside of the penis. It occurs in about 1 in 300 male births and has some genetic factors. Treatment is through surgical urethroplasty to reconstruct the urethra and correct any curvature. Outcomes include some urinary and sexual dysfunction compared to controls, with more issues for proximal versus distal hypospadias. The goal of surgery is a functional penis with normal appearance.
Developmental dysplasia of the hip (DDH) is a spectrum of hip dysplasia that ranges from shallow acetabulum to subluxation to complete dislocation. It is more common in females and affects the left hip more often than the right. Risk factors include breech birth position, torticollis, and a family history. Symptoms may include leg length discrepancy, uneven skin folds, limping, or limited mobility. Diagnosis involves clinical examination including Ortolani's and Barlow's maneuvers as well as imaging like ultrasound and x-rays. Treatment options include use of a Pavlik harness or von Rosen splint for younger infants or surgical reduction and spica casting for older children.
Similaire à Developmental dysplasia of the hip (DDH) (20)
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
2. Introduction
dysplasia of hip that develop during fetal life or in infancy
Old name : CDH
Name changed because not
All cases present at birth,
Some cases may develop
Latter onduring infancy and
Childhood.
3. Spectrum of disease :
Dysplasia—shallow acetabulum
Subluxation
Dislocation
Teratologic—dislocated in utero and irreducible;
associated with neuromuscular conditions and genetic
abnormalities
Late dysplasia (adolescent and adult)
4. Risk factors:
4F :
FEMALE GENDER 85 %
FIRST BORN CHILD
FOOT FIRST (BREECH ) 30 TO 50%
FAMILY HISTORY >20%
DDH is observed most often in the left hip (67% of cases),
Also associated with postnatal positioning such as
swaddling with the hips in extension
5. • Causes:
Mechanical factors:
transverse acetabular ligament,
pulvinar,
infolded labrum,
inferior capsular restriction,
Hypertrophied ligamentum teres,
psoas tendon
Hormones induced ligamentous laxity
Genetic inheretence
Most common intrauterine position of left hip over mother sacrum
Swaddle infants
Maternal hormone relaxin theory
6. Diagnosis:
Mother came with history difficulty in wearing
dippers to her baby.
Physical examination:
• Early diagnosis possible with Ortolani test
(elevation and abduction of femur relocates a
dislocated hip and Barlow test (adduction and
depression of femur dislocates a dislocatable
hip)
• All children should undergo screening via
physical examination.( 1ST DAY OF LIFE,6
WEEKS,3 MONTHS,6 MONTHS,& 1 YEAR)
7. Subsequent diagnosis is made with limitation of hip Abduction
Galeazzi sign
demonstrated by the clinical appearance
of foreshortening of the femur on the affected side
Other clinical findings
include asymmetric gluteal folds (less reliable)
And Trendelenburg stance (in older children),
increased lumbar lordosis,
and pelvic obliquity.
8. Dynamic ultrasonography before ossification of the femoral head (which
occurs at age 4–6 months)
On the coronal view, the normal α angle is greater than 60 degrees, and the
femoral head is bisected by the line drawn down the ilium.
acetabular roofline
inclination line
9. Radiographic studies and findings
older children >4-6 months
acetabular index normal <25 °
centre edge angle of Wiberg normal > 30°
Shenton line
IHDI CLASSIFICATION
TONIS CLASSIFICATION
(femoral head ossification begins to show between 4 and 6 months).
10.
11.
12.
13. Fill the syringe with 5 mL of a 25% strength medically approved contrast agent such as diatrizoate or
iohexol solution and inject 1 to 3 mL through the needle into the joint with image intensification.
14. CT & MRI:
• Advanced imaging (CT, MRI) helpful after closed reduction to
determine concentric reduction
15. Birth to 6 months :
• In hips that have normal examination findings but abnormal
ultrasound findings, treatment recommendations are uncertain
•Children should have close follow-up.
• Repeat ultrasound at age 6 weeks, with treatment if continued signs
of dysplasia
16. Birth to 6 months :
• Pavlik harness
• All Ortolani-positive (dislocated but reducible) hips should be treated with
Pavlik harness.
• Barlow-positive (reduced but dislocatable) hips may stabilize without
treatment but should be watched closely; many writers advocate treating with
Pavlik harness with observation.
• If dislocated, reduction should be checked weekly with ultrasonography for 3
weeks.
• Not reduced: transition to rigid abduction orthosis versus closed reduction,
arthrography, and spica casting should be considered.
• Reduced: continue harness until findings of examination and ultrasonography
are normal.
17. Pavlik harness:
a chest strap, two shoulder straps, and
two stirrups.
Each stirrup has an anteromedial flexion
strap and a posterolateral abduction
strap.
POSITION: SUPINE.
The chest strap is fastened first.
The shoulder straps are adjusted to
maintain the chest strap at the nipple
line.
hip is placed in flexion (90 to 110
degrees), with anteromedial strap.
lateral strap is loosely fastened to limit
adduction.
The knees should be 3 to 5 cm apart at
18. Pavlic harness is applied in about 90 to 110 degrees of flexion and mild
abduction (the “human position” [Salter position])
safe zoneof Ramsey (between maximum adduction before
redislocation and excessive abduction, which
increases risk of avascular necrosis [AVN]).
• Impingement of the posterosuperior retinacular
branch of the medial femoral circumflex artery
narrow safe zone (<40 degrees),
19. • The Pavlik harness should be worn 23 to 24 hours per day until stability
is attained, as determined by negative Barlow and Ortolani tests. During
this time, the patient is examined at 1- to 2-week intervals
• Quadriceps function should be noted at each examination to detect a femoral nerve
palsy, and families should be instructed to remove the legs from the brace daily to
ensure that the infant is able to actively extend the knee against gravity.
• discontinuation of the Pavlik harness 6 weeks after clinical
stability has been obtained.
RISK FACTORS:
• irreducible dislocation
• bilateral hip dislocations
• femoral nerve palsy
• AVN femoral head
20. 6 to 18 months:
percutaneous adductor tenotomy, closed reduction, and spica casting Postreduction CT or MRI
used to confirm concentric reduction
If closed reduction fails: open reduction
18 months to 3 years:
Preoperative traction, adductor tenotomy, and closed reduction and arthrogram or open
reduction in children with a failed closed reduction. Femoral shortening may be needed
in a hip with
3 to 8 years:
• Osteotomy
Salter, Dega, Pemberton, or Staheli procedure
• Older than 8 years:
Osteotomy
• Growth plate open: triple (Steele), double pelvic
(Southerland), Staheli procedure
• Growth plate closed: shelf and Chiari procedures
• Total hip arthroplasty is performed when the child is an adult.
21. Closed and open reduction :
• Closed reduction :
• Performed for patients for whom Pavlik treatment fails and for patients 6
to 18 months of age
• Performed using general anesthesia; procedure includes a physical
examination, arthrography to assess reduction (look for thorn sign on
arthrogram, indicating normal labral position), and hip spica casting with the
legs flexed to at least 90 degrees and in the stable zone of abduction
• CT or MRI often performed to confirm that hip
is well reduced, especially in questionable cases
22. Open reduction :
• Reserved for children 6 to 18 months old in whom closed reduction fails, who have an
obstructive limbus, or who have an unstable safe zone
• Initial treatment for children 18 months and older.
• Anterior approach, especially for patients older than 12 months (less risk to medial
femoral circumflex artery)
• Capsulorrhaphy, adductor tenotomy, and femoral shortening can be performed to
take tension off the reduction, along with an acetabular procedure if severe dysplasia is
present
• Obstacles to reduction:
transverse acetabular ligament,
pulvinar,
infolded labrum,
inferior capsular restriction,
hypertrophied
ligamentum teres,
and psoas tendon
23. anterior approach
.requires more anatomic
dissection.
• pelvic osteotomy can be
performed through this
approach if necessary.
• The medial (Ludloff) approach
• Interval between the iliopsoas
and the pectineus.
• This approach places the medial
circumflex vessels at a higher
risk and associated with
osteonecrosis
• Although the medial approach
allows removal of the
impediments to reduction, it
does not allow capsulorrhaphy
and is, therefore, generally
recommended in infants 6 to 18
months old.
24. ANTERIOR APPROACH: (BEATY; AFTER SOMERVILLE)
anterior bikini incision ( middle of the iliac crest to midline of the pelvis)
Disect sartorius , tensor fasciae latae and rectus femoris tendons and iliac epiphysis (protect LFC nerve)
Perform psoas tendon recession tenotomy in its groove on the superior pubic ramus
Make a T-shaped incision from the most medial aspect of the capsule
Identify and clear mechanical factors that hinder to stable reduction
then head is reduced,if reduction is concentric then close the capsule, suturing the lateral flap of the T-shaped incision as
far medially as possible to eliminate any redundant capsule in the region of the false acetabulum
All layers closed in reverse manner ,double hip spica cast applied
Post op follow up:
Xray, ct scan or mri to check reduction
Spica is changed at 5-6 weeks
Final removal at 10-12 weeks
25. CONCOMITANT OSTEOTOMY
The use of a concomitant osteotomy of the ilium, acetabulum, or femur at
the time of open reduction remains controversial.
Innominate osteotomy, acetabuloplasty, proximal femoral varus derotation
osteotomy, or femoral shortening osteotomy might increase the stability of
open reduction.
However, in younger children (<12 months), acetabular remodeling
potential could render these procedures unnecessary.
26. Zadeh et al. used concomitant osteotomy at the time of open
reduction to maintain stability of the reduction in which
the following test of stability after open reduction was used.
1. Hip stable in neutral position—no osteotomy
2. Hip stable in flexion and abduction—innominate
osteotomy
3. Hip stable in internal rotation and abduction—proximal
femoral derotational varus osteotomy
4. “Double-diameter” acetabulum with anterolateral deficiency—
Pemberton-type osteotomy
27.
28.
29.
30.
31.
32. Surgical risks :
• Osteonecrosis—the major risk associated with both open and closed
reductions; caused by direct vascular injury or impingement versus
disruption of circulation from osteotomies
• Damage to medial femoral circumflex can occur with medial approach to
hip; close association to psoas, which undergoes a tenotomy because it is a
block to reduction.
• Failure of open reduction is difficult to treat surgically because of the high
rates of complication after revision surgery (osteonecrosis in 50% and pain
and stiffness in 33% according to one study)
• Diagnosis after age 8 (younger in patients with bilateral DDH) may
contraindicate reduction because the acetabulum has little chance to
remodel, although reduction may be indicated in conjunction with salvage
procedures.