Talk:Developmental Hip Dysplasia

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Cite this page: Hill, M.A. (2019, July 23) Embryology Developmental Hip Dysplasia. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Developmental_Hip_Dysplasia

2018

Developmental dysplasia of the hip: why are we still operating on them? A plea for institutional newborn clinical screening

Singapore Med J. 2018 May 18. doi: 10.11622/smedj.2018064. [Epub ahead of print]

Lee WC1, Gera SK2, Mahadev A2.

Abstract

INTRODUCTION: Developmental dysplasia of the hip (DDH) is a common orthopaedic condition at birth. Non-surgical management with Pavlik harness can effectively treat DDH with early clinical diagnosis at newborn, but open surgeries continue to be performed. We aimed to elucidate the reasons for this. METHODS: A retrospective review was performed of all open surgeries related to DDH from 2006 to 2016. Patients were either born at our institution (Group 1) or outside of it (Group 2). All Group 1 newborns were routinely screened for DDH at birth. RESULTS: 27 patients (Group 1: n = 5; Group 2: n = 22) presented at 25 ± 19 months old. Left-sided DDH (n = 21; 77.8%) and girls (n = 22; 81.5%) were more common. Mean age at surgery was 40 ± 31 months. The most commonly performed procedure was soft tissue release open reduction with acetabuloplasty (n = 20; 74.1%). Gender, site, median age at presentation and surgery, and prevalence of risk factors were matched for both groups. Both groups were mostly made up of late presenters (presenting after three months) (p = 0.68), with a few patients having had prior treatment (p = 0.64). Newborn screening was the only variable with statistical difference between the groups (p < 0.01). CONCLUSION: Lack of institutionalised newborn clinical screening appears to be the root cause for the late presentation of DDH leading to open surgeries for its management. We recommend quality institutionalised newborn clinical screening to reduce the number of late presentations leading to open surgeries for DDH. KEYWORDS: developmental dysplasia of the hip; newborn screening; open reduction PMID: 29774363 DOI: 10.11622/smedj.2018064


2017

Prevention of hip displacement in children with cerebral palsy: a systematic review

Dev Med Child Neurol. 2017 Jun 2. doi: 10.1111/dmcn.13480. [Epub ahead of print]

Miller SD1, Juricic M1, Hesketh K2, Mclean L3, Magnuson S1, Gasior S3, Schaeffer E1,4, O'donnell M3,5, Mulpuri K1,4. Author information Abstract AIM: To conduct a systematic review and evaluate the quality of evidence for interventions to prevent hip displacement in children with cerebral palsy (CP). METHOD: A systematic review was performed using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Searches were completed in seven electronic databases. Studies were included if participants had CP and the effectiveness of the intervention was reported using a radiological measure. Results of orthopaedic surgical interventions were excluded. RESULTS: Twenty-four studies fulfilled the inclusion criteria (4 botulinum neurotoxin A; 2 botulinum neurotoxin A and bracing; 1 complementary and alternative medicine; 1 intrathecal baclofen; 1 obturator nerve block; 8 positioning; 7 selective dorsal rhizotomy). There was significant variability in treatment dosages, participant characteristics, and duration of follow-up among the studies. Overall, the level of evidence was low. No intervention in this review demonstrated a large treatment effect on hip displacement. INTERPRETATION: The level and quality of evidence for all interventions aimed at slowing or preventing hip displacement is low. There is currently insufficient evidence to support or refute the use of the identified interventions to prevent hip displacement or dislocation in children and young people with CP. © 2017 Mac Keith Press.

PMID: 28574172 DOI: 10.1111/dmcn.13480


2015

Evolution of the term and definition of dysplasia of the hip - a review of the literature

Arch Med Sci. 2015 Oct 12;11(5):1052-7. doi: 10.5114/aoms.2015.52734. Epub 2015 Jun 30.

Musielak B1, Idzior M1, Jóźwiak M1.

Abstract

There is no consensus on the definition of dysplasia of the hip (DH). Past and present concepts used to describe DH do not form a complete view of the pathology. Moreover, some authors still present the disease as congenital, not developmental. This prompted authors to analyze the evolution of the definition of DH. Based on the biomedical databases 500 articles and books in the field of hip dysplasia were found and analyzed. Fifteen definitions of hip dysplasia met inclusion criteria, subsequently were analyzed and presented in chronological order. The analysis revealed that currently there is no single, universal definition of hip dysplasia in the aspect of morphological, clinical, and radiological studies. Despite the widely-used term of DH, it is described imprecisely and in different ways. Therefore, it is necessary to develop a multidisciplinary definition of this pathology covering all aspects of hip disorders considered valid in modern orthopaedics. KEYWORDS: acetabular dysplasia; congenital hip dislocation; developmental dysplasia of the hip; hip dysplasia PMID: 26528350 PMCID: PMC4624737 DOI: 10.5114/aoms.2015.52734