Screening for Developmental Dysplasia of the Hip
Linda M. French, M.D. et al, Oakwood Healthcare System, American Academy of Family Physicians
 [for Professionals mainly]
Screening programs relying primarily on physical examination techniques for the early detection and treatment of congenital hip abnormalities have not been as consistently successful as expected ... The natural history of developmental dysplasia of the hip is not completely understood ... A more recent British study employing universal ultrasound examination of the hips in 14,050 newborns found that 90 percent of ultrasonographic abnormalities normalized spontaneously without treatment and that no infants with ultrasonographically normal hips at birth presented later with dislocations ... Ortolani and Barlow Maneuvers: The Ortolani and Barlow maneuvers have been the standard techniques for detecting hip instability in newborns9 (Figure 1). These maneuvers cannot be performed in a fussy, crying infant whose muscle activity may inhibit the movement of an unstable hip. For the examinations, the infant's hips are flexed to 90 degrees; the thumbs of the examiner are placed on the medial proximal thigh, and the long fingers are placed over the greater trochanter. For the Ortolani maneuver, the contralateral hip is held still while the thigh of the hip being tested is abducted and gently pulled anteriorly. The sensation of instability in a positive Ortolani maneuver is the palpable and sometimes audible "clunk" of the femoral head moving over the posterior rim of the acetabulum and relocating in the cavity ... Ortolani maneuver must be performed very gently to avoid obscuring the sound of the femoral head passing over a poorly developed posterior acetabulum ... The Barlow maneuver is performed by adducting the hip while pushing the thigh posteriorly ... Other investigators have popularized ... real-time ultrasonography to visualize the hips during physical examination ... Some concerns have been raised about the reliability of ultrasonographic imaging of the infant hip ...
Congenital Hip Dislocation (Infantile Hip Dislocation) (Congenital Dislocation of the Hip) (CD) (Developmental Dysplasia of the Hip) (DDH)
Children's Virtual Hospital October 19, 2006
The Ortolani/Barlow maneuver is used in which you attempt dislocation of the flexed hip by abduction of the proximal femur producing a click on posterior dislocation and another as the femoral head slides back into the acetabulum with adduction. Seen in 0.25-0.85% of newborns with a female to male predominance of 8:1. Most are unilateral and usually are on the left ...
Developmental dysplasia of the hip
Charles E. Kahn Jr., MD, September 1, 2006
Congenital hip dislocation ... females (80-90%) ... white > blacks ... associated: breech delivery, C-section, torticolis, family history ... LEFT (70%); bilateral in only 5% ... Putti's triad - supero-lateral migration of femoral head, increased acetabular angle, small capital femoral epiphysis.
Education Modules
Alfred I. duPont Institute of The Nemours Foundation Wilmington, Delaware
... General Medical ... General Orthopaedist ... Pediatric Orthopaedist ...
Displasia del desarrollo de la cadera en la atención primaria
Dr. Luis Miguel Pérez Hernández et al., Rev Cubana Ortop Traumatol v.2003 n.1-2 Ciudad de la Habana ene.-dic. 2003
[Spanish]
La importancia de la displasia del desarrollo de la cadera en la Ortopedia persiste ... Displasia (del griego dys que significa mal y plássien, modelar) es un término que hace referencia a la presencia de un amplio espectro de anormalidades en la conformación de la articulación desde edad temprana, que abarcan desde formas muy leves, sólo detectables por Rx, hasta su anormalidad más severa, la luxación, que es la salida de la cabeza femoral del acetábulo y que si no es tratada adecuadamente puede dejar limitación de la capacidad funcional de la cadera con claudicación de importancia variable, dolor articular y deformidad en pelvis y columna ... aparición de esta entidad es aproximadamente de 1-2 por 1 000 nacidos vivos ... En los indios americanos, la relación es de 30 por 1 000 ... es más frecuente en el sexo femenino ...
La Displasia Congénita de Cadera (DCC)
University of Virginia Health System, April 23, 2007
[Spanish]
un trastorno congénito (presente al nacer) de la articulación de la cadera ... en uno de cada 1.000 nacidos vivos ... una articulación de bola y cótilo. En la DCC, el cótilo (o acetábulo) de la cadera puede ser poco profundo ... La "bola" puede salirse en forma parcial o total del acetábulo ... la pierna puede parecer más corta del lado de la cadera luxada
... la pierna del lado de la cadera luxada puede inclinarse hacia afuera
... los pliegues en la piel del muslo o las nalgas pueden parecer desparejos ... es a veces evidente en el nacimiento ... puede también no descubrirse sino hasta realizar exámenes posteriores ...
Hip Dislocation
I.B.I.S. Birth Defects, July 21, 2002
[Ukrainian]
Fact Sheet for Parents in Ukrainian
Description ... Causes ... Features and symptoms ... Diagnosis ... Complications ... Treatment
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Last Updated: 2008/2/20
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