Late presentation of developmental dysplasia of the hip

Gul, Rehan; Coffey, J. Calvin; Khayyat, G.; McGuinness, A.

doi:10.1007/bf03170500

Cited by 18 publications

(14 citation statements)

References 20 publications

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“…The sustained subluxation or dislocation of the femoral head over time does not permit normal development of the acetabulum and results in a predictable pattern of acetabular growth disturbance that is termed hip dysplasia (strong evidence) 2 . Although the rate of occurrence of DDH has been substantially reduced as a result of better clinical assessment, especially with the availability of sonographic hip screening, 3 there are still some cases that present in older patients as a result of late or missed diagnoses 4 . After walking age, the choice of treatment for DDH continues to be controversial.…”

Section: Introductionmentioning

confidence: 99%

Tratamento cirúrgico de displasia de desenvolvimento do quadril de apresentação tardia depois da idade da marcha

2013

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OBJECTIVE: Cases of developmental dislocation of the hip (DDH) still occur after walking age because of late or missed diagnosis and failed conservative treatment. The choice of treatment for DDH after walking age continues to be controversial, and one of the options is open reduction combined with innominate osteotomy. METHODS: Twenty patients with 26 surgically treated hips with DDH, were evaluated from 2005 to 2008, using innominate osteotomy by Salter's technique after open reduction and capsulorraphy. The age of patients, fifteen females and five males, at time of surgery ranged from 12 to 18 months (mean age 14.7 months). Six patients had bilateral dislocation and in the remaining, nine had their left hip dislocated and five had their right hip dislocated. RESULTS: The results were evaluated according to modified McKay criteria and to Severin radiological criteria, after a mean follow-up of 46.7 months. Eighty - nine percent of hips were rated as excellent or good by McKay criteria. There were no poor results. According to Severin criteria, 77% were type I and II while 23% showed type III and IV, no hips were rated as Severin's group V or VI. There was one case (3.8%) of re-dislocation, but revision surgery resulted in stable, concentric, and permanent reduction. No cases of infection, graft fracture and vascular or nervous injury were reported. CONCLUSION: Open reduction combined with Salter osteotomy does not hurt the hip with regard to acetabular remodeling for children between 12 and 18 months of age. Level of Evidence IV, Case Series.

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Section: Introductionmentioning

confidence: 99%

Tratamento cirúrgico de displasia de desenvolvimento do quadril de apresentação tardia depois da idade da marcha

2013

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“…It can be detected early soon after delivery by clinical examination and ultrasound screening. Early screening proved to reduce the incident of delayed presentation of DDH 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Clarke et al defined the late presentation as any child presented with DDH more than 3 months of age 11 , whereas R Gul et al choose presentation more than of 6 months old are considered late presentation 10 . In this study we defined late presentation as the presentation for the first consultation at beyond 6 months of age.…”

Section: Discussionmentioning

confidence: 99%

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The Economic Impact of Managing Late Presentation of Developmental Dysplasia of Hip (DDH)

Anuar¹,

Mohd-Hisyamudin²,

Ahmad³

et al. 2015

MOJ

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Delayed presentation of Developmental Dysplasia of Hip (DDH) comes with challenges in treatment as well as high surgical cost. Therefore the objective of this study is to quantify the economic impact of management of late presentation of DDH during a last 3-year period. We conducted a retrospective study with analysis of DDH cases managed between years 2012 to 2014. Early and late presentations of DDH were identified and cost management for both was estimated. Out of twenty-four DDH cases, thirteen cases fulfilled the inclusion criteria. All were female with majority of them presenting with unilateral DDH predominantly of the left hip. Most patients presented after age of six months and the principal complaint was abnormal or limping gait. The grand total cost for managing DDH during the three years period was USD 12,385.51, with 86% of the amount having been used to manage late presentation of DDH that was mostly contributed by the cost of surgery. We concluded that delayed presentation of DDH contributes heavily to high national expenditure. Early detection of DDH cases with systematic neonatal screening may help to minimize the incidence of the late presenting DDH and subsequently reduce the economic burden to the government.

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“…It is difficult to analyze the surgical techniques due to differing trends in preferred surgical options [10]. It is clear, however, that those who presented after 3 months had a worse prognosis for treatment, requiring a mean of 2.1 surgical procedures (range, 0-6 procedures), compared to those who were diagnosed before 3 months of age who required a mean of one (range, 0-3 procedures).…”

Section: Discussionmentioning

confidence: 99%

Developmental Dysplasia of the Hip and Occult Neurologic Disorders

Luther

Clarke

2008

Clinical Orthopaedics &Amp; Related Research

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Developmental dysplasia of the hip (DDH) is a neonatal condition with various causes. Neuromuscular dysplasia of the hip (NDH) is a sequel of neuromuscular disease, and generally presents later in childhood than DDH. Some evidence, however, supports a concept of a neuromuscular etiology of DDH: (1) a high prevalence of spinal dysraphism in DDH; and (2) abnormal sensory evoked potentials in 31% of DDH patients. To explore this suggestion we ascertained the presence of neuromuscular disease within a cohort of DDH patients, and asked whether the neuromuscular condition is the initial etiology of the dysplasia or a coincidental finding. We retrospectively reviewed patients presenting with DDH. Only those with an initial diagnosis of DDH and a subsequent diagnosis of a neuromuscular condition were assessed. Fifteen of 560 patients fulfilled the criteria, however the presence of true DDH within this group was minimal, as several cases emerged as early presenting NDH. We therefore believe it unlikely DDH has a substantial neurological etiology.

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Late presentation of developmental dysplasia of the hip

Abstract: Despite screening, children continue to present with late DDH. In this study, only 14 patients had multiple risk factors and only four patients had more than two risk factors, highlighting the low incidence of suspicion in this patient group.

Cited by 18 publications

References 20 publications

Tratamento cirúrgico de displasia de desenvolvimento do quadril de apresentação tardia depois da idade da marcha

Tratamento cirúrgico de displasia de desenvolvimento do quadril de apresentação tardia depois da idade da marcha

The Economic Impact of Managing Late Presentation of Developmental Dysplasia of Hip (DDH)

Developmental Dysplasia of the Hip and Occult Neurologic Disorders

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