Presentation and Management of Neglected Developmental Dysplasia of Hip (DDH): 8-years’experience with single stage triple procedure

Zimri, Farid Ullah Khan; Shah, Syed Shujaat Ali; Saaiq, Muhammad; Qayyum, Faisal; Ayaz, Muhammad

doi:10.12669/pjms.343.14392

Cited by 6 publications

(4 citation statements)

References 16 publications

(17 reference statements)

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“…The goal of surgery is to reposition the femoral head and restore normal anatomy to prevent long-term complications such as pain, difficulty walking, and arthritis. However, other studies conducted in Pakistan, have reported non-operative approaches to be effective as well, particularly in mild cases [ 16 ]. This is because they are less invasive and have fewer risks than surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Breech Presentation and Other Gestational/Delivery Characteristics Among Patients Born With Developmental Dysplasia of the Hip

Khabiah,

M. Al Hunaif,

Al Mudawi

et al. 2023

Cureus

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IntroductionDevelopmental dysplasia of the hip (DDH) is the most common congenital disability in newborns. The condition can range from a slight laxity in the hip joint to secondary femoral head injury, early osteoarthritis (OA), and mobility issues. There are several risk factors for DDH, including positive family history, female sex, breech presentation, and the presence of clubfoot. Early detection and treatment are crucial to avoid long-term hip dysplasia and arthritis, which can cause difficulty in walking and discomfort. Breech presentation, in particular, is a significant risk factor for DDH, with spontaneous vaginal birth increasing the risk of hip pathology and instability compared to elective Caesarean section. However, whether breech presentation continues to be a risk factor for DDH in preterm children is unknown. Objective and methodsThis study aimed to investigate the prevalence of breech presentation and other gestational/delivery characteristics among newborns diagnosed with DDH. This retrospective study was conducted at Abha Maternity and Children Hospital, Abha, Saudi Arabia, over a period of six months. Data were collected from medical records of DDH cases diagnosed between 2016 and 2023. Data analysis was performed using Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States) and IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). Descriptive statistics and statistical tests were used to analyze the data. ResultsMost of the diagnosed children were female (86.7%), and bilateral hip dislocation (40%) was the most common presentation. X-ray was the most common diagnostic tool (48.3%), and operative management was the most common management strategy (73.3%). A positive family history of DDH was reported in more than one-third of cases. The study also analyzed the association between complications during pregnancy and various factors such as mode of delivery, presentation at delivery, gestational age at delivery, and associated maternal diseases. The difference in complication rates between women who delivered via Csection and those who delivered vaginally was insignificant (p = 0.14). Similarly, the difference in complication rates between women with breech and cephalic presentation was not statistically significant (p = 0.094). The difference in complication rates between women who delivered preterm, at term, or postterm was also not statistically significant (p = 0.578). Furthermore, the association between complications during pregnancy and pregnancy-associated maternal diseases was not statistically significant (p = 1.00). ConclusionDDH is a significant health issue in newborns, leading to long-term mobility problems and discomfort. Positive family history of DDH is a significant risk factor. Breech presentation was not significantly associated with DDH in preterm children, and no significant associations were found between complications during pregnancy and various factors. Early detection and treatment of DDH are crucia...

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Section: Discussionmentioning

confidence: 99%

Prevalence of Breech Presentation and Other Gestational/Delivery Characteristics Among Patients Born With Developmental Dysplasia of the Hip

Khabiah,

M. Al Hunaif,

Al Mudawi

et al. 2023

Cureus

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“…In our country, as there is no screening program for at-risk children, the mean age of presentation is above 2 years as reported in previous studies. (10)(11)(12) . Therefore, our sample size was small and about 20 hips were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Short-Term Outcomes of Open Reduction of Development Dysplasia of the Hip by Medial Approach: Our Experience at Khyber Teaching Hospital Peshawar

Zafar

Hayat²,

Zaman

et al. 2022

JMS

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Objective Our study aimed to determine the short-term outcome of open reduction by medial approach in terms of function, joint reduction, and avascular necrosis. Methods This was a Descriptive study approved by the institutional review board. We performed open reduction by medial approach in 24 hips in children less than 18 months of age. We followed them for a mean of 32 months ± 10.5 months. The average age of surgery was 9.7 months ± 3.5 months. Results Out of 24 hips, 22 were successfully reduced and two hips required revision surgery for post-operative redislocation of the hip joint. Avascular necrosis was noted in three hips and functionally classified according to McKay criteria 22 hips showed excellent one hip good, and one hip fair outcome. Conclusion We concluded that the medial approach is effective and reliable in achieving good short-term outcomes. It is safe and easy with a low rate of complications performed in children less than 18 months of age. Keywords: development dysplasia of hip joint, DDH, medial approach, open reduction, short-term follow-up, Avascular necrosis.

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“…Genetic explanations may be the cause for the higher frequency in female children and those with a positive family history. An increased incidence of breech deliveries, advanced maternal age, postmaturity, oligohydramnios, or any other crowded intrauterine situation are examples of mechanical factors [ 8 ]. Compared to the healthy side, there is less abduction in hip dislocations.…”

Section: Introductionmentioning

confidence: 99%

Impact of Early Rehabilitation in a Four-Year-Old Patient With Developmental Dysplasia of Hip: A Case Report

Baheti,

Phansopkar

2024

Cureus

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Developmental dysplasia of the hip (DDH) represents a complex spectrum of hip abnormalities, varying from mild dysplasia to severe dislocation, significantly impacting biomechanics and joint stability. This study explores the intricate pathogenesis of DDH, emphasizing its articular and periarticular anatomical anomalies and their profound implications. Factors such as breech positioning, advanced maternal age, postmaturity, and intrauterine crowding contribute to the complexity of DDH's etiology. The fetal development of the hip joint, crucial for understanding DDH, involves intricate processes starting from the fourth week of gestation. Any disruption during this period can lead to abnormal hip development, necessitating early detection and intervention. This is a case presentation of a four-year-old girl with bilateral DDH in detail, highlighting the clinical findings, diagnostic procedures, and physiotherapeutic management employed. A tailored physiotherapy plan was implemented, focusing on pain management, pressure sore prevention, respiratory care, and muscle strength preservation. This study highlights the need for further research in this area by illuminating the complexities of DDH. Despite difficulties and limitations in the literature, interest in researching different facets of DDH is expanding.

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Presentation and Management of Neglected Developmental Dysplasia of Hip (DDH): 8-years’experience with single stage triple procedure

Cited by 6 publications

References 16 publications

Prevalence of Breech Presentation and Other Gestational/Delivery Characteristics Among Patients Born With Developmental Dysplasia of the Hip

Prevalence of Breech Presentation and Other Gestational/Delivery Characteristics Among Patients Born With Developmental Dysplasia of the Hip

Short-Term Outcomes of Open Reduction of Development Dysplasia of the Hip by Medial Approach: Our Experience at Khyber Teaching Hospital Peshawar

Impact of Early Rehabilitation in a Four-Year-Old Patient With Developmental Dysplasia of Hip: A Case Report

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