Developmental Dysplasia of the Hip: Management of Graf IIa Dysplastic Hip

Raba, Ali Ahmed; Gasibat, Qais

doi:10.4236/ojped.2020.102025

Cited by 4 publications

(6 citation statements)

References 21 publications

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“…Developmental dysplasia of the hip (DDH) encompasses a wide spectrum of pathology, ranging from complete fixed dislocation at birth to asymptomatic acetabular dysplasia in adulthood [ 1 ], which can negatively affect hip development and can lead to isolated acetabular dysplasia, subluxation, complete dislocation of the hip joint, or permanent abnormal gait [ 2 , 3 ]. The children with untreated persistent DDH may suffer from pain due to a series of anatomical changes such as increased abnormal articular pressure or increased tension on a smaller contact area during the process of growth and development.…”

Section: Introductionmentioning

confidence: 99%

Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging

et al. 2020

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Background The developmental dysplasia of the hip (DDH) can cause a wide range of pathological changes, and often requires surgical treatment. Preoperative evaluation is very important for DDH. We aimed to assess the diagnostic capability of magnetic resonance imaging (MRI) for irreducible aspects preventing hip reduction in DDH. Methods A total of 39 pediatric patients who received DDH evaluation in pediatric orthopedics from January 2015 to December 2019 were included. The samples included 4 cases of bilateral DDH and 35 cases of unilateral DDH, a total of 43 hip joint samples. All patients underwent surgical treatment, pathological examination and MRI of hip joint. Results With pathological results or intraoperative findings as the gold standard, the sensitivity and specificity of MRI were 90.3% and 83.3% for the affected labrum, 92% and 83.3% for thickening of the round ligament, 90.0% and 91.3% for atrophy of the iliopsoas muscle, and 100% and 100% for fibrofatty pulvinar tissue and joint effusion, respectively. Conclutions The MRI showed an extraordinary capability of detecting these irreducible factors and helped surgeon choose the appropriate treatment strategies.

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Section: Introductionmentioning

confidence: 99%

Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging

et al. 2020

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“…[10] However, another study reported a prevalence ranging from 5% to 12%, which is in line with our findings. [11] This suggests that the inconsistency in ranges might be attributed to the different timing of US examination. The results of the current study revealed that 45% of infants with DDH exhibited bilateral involvement.…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 – 8 ] The screening of infants suspected of having DDH lacks consensus and comprehensive studies. [ 9 – 11 ] In Saudi Arabia, the practice of screening newborns with US is not yet commonplace. Therefore, this study investigated the incidence of DDH among infants at King Abdul-Aziz University in Jeddah to better understand the DDH incidence rate and emphasize the importance of screening newborns using US.…”

Section: Discussionmentioning

confidence: 99%

Incidence and characteristics of developmental dysplasia of the hip in a Saudi population: A comprehensive retrospective analysis

Almutairi

2024

Medicine

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Developmental dysplasia of the hip (DDH) is a common hip disorder in infants. Ultrasonographic screening is considered the most reliable method for early detection of DDH in newborn infants. This study aimed to determine the incidence of DDH at King Abdulaziz University Hospital. From January 2017 to December 2018, this retrospective study analyzed the data of 8031 infants who underwent an early clinical examination of the hips. At the initial evaluation, 212 infants referred to the ultrasound department had risk factors for DDH and/or clinical instability. Different well-known risk factors of DDH have been identified including breech position, skeletal deformities, positive family history, hip side, sex and clicky hip. The findings revealed an incidence rate of 93 cases of DDH among 8031 infants (11.58 per 1000) births. Among the infants diagnosed with DDH, 55 were females (59.14 %), and 38 were males (40.86%). The results of the current study revealed that 45% of infants with DDH exhibited bilateral involvement. Moreover, results showed that the IIa hip joint was more prevalent in female than in male newborns, but without any significant difference. The incidence rate of DDH in this study was 11.58 per 1000 live births, and it was more prevalent among female than male newborns. Ultrasonography (US) should be used as a complementary imaging modality for clinical examination of DDH. Infants with breech presentation, clicky hip, and skeletal deformity should be scanned by US. Further prospective studies are recommended.

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“…The alpha angle consists in the bony roof angle, and the beta angle consists in the cartilage roof angle. According to this method, type I hips are considered mature, whereas type III hips are considered immature [ 6 ]. To treat DDH, experts recommend a noninvasive approach that focuses on timely interventions such as splints, braces, and harnesses that are tailored to the age and severity of the condition [ 3 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of developmental hip dysplasia with manual therapy following Pavlik harness failure: a case report with long-term follow-up

Giorgi,

Apostolo,

Bertelè

2024

Journal of Manual & Manipulative Therapy

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Background Developmental dysplasia of the hip (DDH) is a common musculoskeletal disorder in newborns, ranging from mild dysplasia to complete dislocation. Early detection and intervention are crucial for managing DDH. However, in some cases, standard orthopedic treatments such as the Pavlik harness fail, and alternative approaches are needed. Our study explores the possibility that manual therapy, specifically the Mézières-Bertelè Method (MBM), could be beneficial in cases of DDH that are resistant to conventional treatments. Case Description We present a case of a 20-month-old female who had been suffering from persistent DDH (Graf’s type IIIC on the left), pain and limping, despite previous conventional treatments, including the Pavlik harness. The patient received daily MBM sessions for six months, followed by maintenance sessions every two months. Outcomes After undergoing the MBM treatment, the patient showed clinical improvements, such as normal neuromotor development and restored hip joint parameters. We observed normal walking and running abilities, and X-ray parameters returned to normal levels. The patient sustained positive outcomes during long-term follow-up until the age of 7. Conclusion The MBM manual therapy was used to treat a challenging case of DDH resistant to conventional treatment. This case report suggests a possible correlation between manual therapy and improved outcomes in resistant DDH and highlights the potential relevance of addressing the inherent musculoskeletal components of the condition.

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Developmental Dysplasia of the Hip: Management of Graf IIa Dysplastic Hip

Cited by 4 publications

References 21 publications

Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging

Assessment of irreducible aspects in developmental hip dysplasia by magnetic resonance imaging

Incidence and characteristics of developmental dysplasia of the hip in a Saudi population: A comprehensive retrospective analysis

Treatment of developmental hip dysplasia with manual therapy following Pavlik harness failure: a case report with long-term follow-up

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