Developmental Dysplasia of the Hip in Young Children

Weinstein, Stuart L.; Holt, Joshua

doi:10.1007/978-3-030-12003-0_4

Cited by 4 publications

(6 citation statements)

References 287 publications

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“…The natural history of DDH does not include the presence of dermatitis, avascular necrosis of the femoral head, femoral nerve palsy, or in fact, any other of the complications inherent to its treatment 13. Our results do not mean that treatment should not be instituted; on the contrary, the risk of leaving a hip untreated implies life-changing disability and pain.…”

Section: Discussionmentioning

confidence: 72%

What Are the Rate and Risk Factors for Developing a Complication With the Pavlik Method for the Treatment of Hip Dysplasia?

Masrouha

Gibon

Roof

et al. 2021

Journal of Pediatric Orthopaedics

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Background: The Pavlik method for the treatment of developmental dysplasia of the hip (DDH) has been proven successful for over 85 years. The high success rate and reproducibility have made it the mainstay of treatment. Methods: We performed a retrospective cohort study of patients with DDH treated with the Pavlik method between September 2016 and August 2018 with at least 24 months of follow up in a single academic center. We excluded patients with neuromuscular conditions, teratologic dislocations, and arthrogryposis. We identified and included a total of 307 patients in the analysis. There were 66 patients with dysplasia, 97 with instability, and 144 with a dislocation. Data collected included age at initiation of the Pavlik method, diagnosis (isolated dysplasia, subluxation, or dislocation), duration of treatment, follow up duration and any complication. At final follow up, anteroposterior radiographs of the pelvis were used to determine the Severin classification. Results: Major complications were proximal femoral growth disturbance (5.8%) and femoral nerve palsy (0.98%). Multivariate analysis showed that an initial diagnosis of a dislocated hip (odds ratio, 2.20; P < 0.01), was significantly associated with developing a complication. At final follow up, we found Severin type I or II radiographic findings in 100% of patients with dysplasia, 95% of patients with instability and 54% of patients with dislocation (P = 0.001). Conclusions: Complications are not entirely uncommon when the Pavlik method is used for the treatment of DDH. The overall rate of major complications was 7%. The Pavlik method is safe, and independent risk factors for complications were being over 5 months of age and having a dislocated hip at initial presentation.

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Section: Discussionmentioning

confidence: 72%

What Are the Rate and Risk Factors for Developing a Complication With the Pavlik Method for the Treatment of Hip Dysplasia?

Masrouha

Gibon

Roof

et al. 2021

Journal of Pediatric Orthopaedics

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“…DDH is a spectrum of disorders affecting the developing hip, ranging from slight loosening of the ligaments to complete dislocation. 14,15 The prognosis is unpredictable, and several studies are on how to screen for hip dysplasia early and which signs are more clinically meaningful. 14,[16][17][18][19][20][21] Although skin fold asymmetry is not considered clinically significant by many physicians, 15 this sign has been described as one of the important suggestive findings of DDH.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 The prognosis is unpredictable, and several studies are on how to screen for hip dysplasia early and which signs are more clinically meaningful. 14,[16][17][18][19][20][21] Although skin fold asymmetry is not considered clinically significant by many physicians, 15 this sign has been described as one of the important suggestive findings of DDH. 16,17 Many reports recommend referral to a specialist hospital if the physical examination reveals positive signs such as skinfold asymmetry, leg length discrepancy, and hip click, but clinicians may not be well-trained to master these methods.…”

Section: Discussionmentioning

confidence: 99%

Screening for musculoskeletal system malformations and birth injuries in newborns: Results of a screening program in two hospitals in Shenzhen, China

Zhao

Deng

Qiu

et al. 2022

Pediatric Investigation

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Importance: There are a variety of musculoskeletal malformations and injuries that can occur in newborns. These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately. There is no systematic and wellestablished screening program for neonatal musculoskeletal malformations and injuries in China now. Objective: To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City, to explore and discuss the details of the screening procedure and improve future prevention and treatment. Methods: From October 2013 to May 2014, 2564 one-day-old newborns were screened by a pediatric orthopedic physical examination, in combination with ultrasonography when required, and the incidence and variety of diseases were recorded statistically. Results: Among 2564 screened newborns, the following musculoskeletal conditions were identified: congenital muscular torticollis (CMT) (seven cases, 0.27%), hip subluxation (four cases, 0.16%), hip dysplasia (47 cases, 1.83%), congenital talipes equinovarus (CTEV) (two cases, 0.08%), congenital talipes calcaneovalgus (15 cases, 0.58%), polydactyly (nine cases, 0.35%), syndactyly (one case, 0.04%), and spinal hemivertebra (one case, 0.04%). Additionally, there were five (0.19%) neonates with birth injuries. Interpretation: It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China. This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.

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“…D evelopmental dysplasia of the hip (DDH) is a spectrum of pathologies that involves the malformation of both the acetabulum and femur because of the inability to properly form the hip in children. 1 Untreated DDH causes hip deformity and pain, which eventually leads to chronic hip disability, making it the most common cause of secondary osteoarthritis in adults. 2 Therefore, we aim to achieve better integrity through appropriate correction at an early age to reduce the stress on the joint and avoid premature destruction of the labrum and cartilage.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Appropriate Surgical Timing of Salter Innominate Osteotomy for Residual Acetabular Dysplasia in Children

Sawamura¹,

Kitoh

Kaneko³

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Salter innominate osteotomy (SIO) provides favorable results for treating residual acetabular dysplasia in young children. In this study, we examined the midterm results of SIO according to the age at surgery to determine the optimal timing of this procedure. Methods: We retrospectively examined 50 hips of 42 patients (8 boys and 34 girls) with acetabular dysplasia who underwent SIO and were followed up until skeletal maturity. The centeredge angle (CEA) was measured based on the anteroposterior radiographs of the hip obtained before surgery, 5 weeks after surgery, and at the latest follow-up. Severin classification was evaluated at the latest follow-up. Patients were categorized into 3 groups according to age at surgery: younger than 7 years of age (group A), 7 to 8 years of age (group B), and 9 years of age or older (group C). Results:The mean preoperative CEA level of 0.9 degrees improved to 17.1 degrees postoperatively, which was increased to 28.1 degrees at the latest examination. Overall, 45 hips (90%) were classified as Severin I or II, with 96% in group A, 94% in group B, and 57% in group C. In group C, postoperative acetabular coverage was similar to that in the other groups (16.6 degrees in group A, 14.8 degrees in group B, and 18.1 degrees in group C), although the final outcome was unsatisfactory. The average improvement in CEA from postoperative to skeletal maturity was significantly smaller in group C than in the other groups (12.7 degrees in group A, 11.3 degrees in group B, and 3.0 degrees in group C). Conclusions: SIO showed favorable outcomes with satisfactory acetabular coverage at skeletal maturity. However, satisfactory acetabular coverage could not be obtained in some older patients because of limited postoperative remodeling capacity and smaller secondary improvement of CEA. We recommend that SIO should be performed in patients aged 8 years or younger.

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Developmental Dysplasia of the Hip in Young Children

Cited by 4 publications

References 287 publications

What Are the Rate and Risk Factors for Developing a Complication With the Pavlik Method for the Treatment of Hip Dysplasia?

What Are the Rate and Risk Factors for Developing a Complication With the Pavlik Method for the Treatment of Hip Dysplasia?

Screening for musculoskeletal system malformations and birth injuries in newborns: Results of a screening program in two hospitals in Shenzhen, China

Appropriate Surgical Timing of Salter Innominate Osteotomy for Residual Acetabular Dysplasia in Children

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