Developmental Hip Dysplasia

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pediatric clinical clips — March 2018 developmental hip dysplasia

author Julia Circle case study MPAS, PA-C, physician assistant, Baby Girl is a 10-day-old female pediatric orthopedics referred to the orthopedic clinic by her pediatrician for evaluation of her Pediatric Clinical hips. She is brought in by her mother Clips presented by and father. She is their first child. She Dayton Children’s was born full-term, via uneventful Advanced Practice C-section due to breech positioning. Professionals Mom reports no complications during provides quick delivery. Baby girl is breastfed and reviews of common gaining weight well with no other pediatric conditions. reported health concerns. Mom states they were referred for “instability” in Ortolani maneuvers can indicate Dayton Children’s the hips. Mom reports that maternal case discussion instability. A dislocatable hip can be is the region’s pediatric grandfather, great uncle and a displaced posteriorly out of socket referral center for a cousin were braced as children for Developmental Hip Dysplasia with the Barlow maneuver and may be 20-county area. As “congenital hip problems.” (DDH) is a common childhood reduced (“clunk”) with the Ortolani the only facility in orthopedic diagnosis with an abduction elevation maneuver. On physical exam, Baby Girl is an the region with a incidence of 1/100 infants with Later in infancy, limited wide hip appropriately interactive newborn. full-time commitment complete dislocation in 1/1000 abduction becomes more indicative to pediatrics, Dayton She has mild flatness to the right infants. DDH describes a wide of a dysplastic hip due to soft tissue Children’s offers a wide side of her head and stiffness with spectrum of abnormality varying changes in and around the hip capsule. range of services in right lateral motion of the neck from a mildly shallow acetabulum to A positive Galeazzi sign can indicated general pediatrics with palpable tightness in the complete dislocation of the hip. Mild a limb length difference due to a as well as in 35 sternocleidomastoid on the left side. hip dysplasia is cited as a main cause posteriorly dislocated hip. Hip “clicks” subspecialty areas She has normal upper extremities. of adult degenerative arthritis. The and asymmetric thigh folds can be for infants, children Her spine is straight with a hairy most devastating complication of hip common in normal infants and are and teens. We welcome patch and sacral dimple. She has a dysplasia is femoral head avascular not exclusive to hip dysplasia. your inquiries about necrosis (AVN). services available — positive Galeazzi sign on the left side It is important to evaluate for call 937-641-3666 or with positive Barlow and Ortolani The etiology of DDH is multifactorial. associated conditions. The specific email marketing @ maneuvers. The right hip feels Major risk factors include first born, genetic relationship and etiology childrensdayton.org. subluxable, but is stable. Normal thigh female, frank breech, and family his- of these conditions is further being folds. She has active quadricep muscle tory. Other contributors can include researched, but (just as in our case function bilaterally. She has a normal oligohydramnios and swaddling. study) congenital muscular torticollis lateral border of both feet. Early diagnosis is extremely important is found in 20 percent of DDH in order to affect the natural history patients. Also evaluate for metatarsus What is her diagnosis and the next of the condition. Careful physical adductus, club feet and congenital most important step in treatment? exam directed to the age of the patient knee dislocation. is appropriate. Initially, Barlow and Nonprofit Organization U.S. Postage Paid Permit Number 323 Dayton Children’s Hospital Dayton, Ohio One Children’s Plaza

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208-217. 208-217.

WA: Wolters Kluwer; 2016: 2016: Kluwer; Wolters WA:

Orthopedics. 5th ed. Seattle, Seattle, ed. 5th

dysplasia and to confirm reduction. reduction. confirm to and dysplasia

Fundamentals of Pediatric Pediatric of Fundamentals

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Circle Julia

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authors

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