scholarly journals Double Diapering Ineffectiveness in Avoiding Adduction and Extension in Newborns Hips

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 179
Author(s):  
Maurizio De Pellegrin ◽  
Chiara Maria Damia ◽  
Lorenzo Marcucci ◽  
Desiree Moharamzadeh
Keyword(s):  
Birth Weight ◽  
Statistical Analysis ◽  
Developmental Dysplasia ◽  
T Test ◽  
Type I ◽  
Average Birth Weight ◽  
Hip Abduction ◽  
Favorable Influence ◽  
Hip Flexion ◽  
Dysplasia Of The Hip

Hip flexion and abduction is fundamental for developmental dysplasia of the hip (DDH) treatment. At present, double diaper treatment has been inappropriately adopted when DDH is suspected. The aim of this study was to verify whether double diapers influence a newborn’s hip position. Here, we studied 50 children (23 female; 27 male; average age 62.33 ± 20.50 days; average birth weight 3230 ± 447 g) with type I hips according to Graf. At the same time of the ultrasound (US) examination, the following hip positions were measured using a manual protractor: (1) spontaneous position, supine on the outpatient bed without a diaper; (2) spontaneous position, with a double diaper; and (3) squatting position on the caretakers’ side. Statistical analysis was performed with a t-test to compare between (1) the spontaneous position without a diaper and with double diapers; (2) the spontaneous position with double diapers as well as the squatting position on the caretakers’ side with a diaper. The comparison between the hip position without diaper and with double diapers was statistically not significant for all measurements, i.e., right hip flexion (p < 0.33), left hip flexion (p < 0.34), and right and left hip abduction (p < 0.87). The comparison between the hip position with double diapers and on the caretakers’ side was statistically significant for all measurements, i.e., right hip flexion (p < 0.001), left hip flexion (p < 0.001) and right and left hip abduction (p < 0.001). We found that the use of double diapers did not affect hip position, while the position formed on the caretaker’s side shows favorable influence.

scholarly journals Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study

2019 ◽  
Vol 13 (2) ◽  
pp. 161-166 ◽  
Author(s):  
H. Ömeroğlu ◽  
A. Akceylan ◽  
N. Köse
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Hip Dysplasia ◽  
Positive Family History ◽  
Significant Risk ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Dysplasia Of The Hip

Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened. Level of Evidence Level III prognostic study

scholarly journals Closed Reduction in Developmental Dysplasia of the Hip in Patients Older than One Year

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 276-281
Author(s):  
Zoran Bozinovski ◽  
Milena Bogojevska Doksevska ◽  
Keti P. Tokmakova
Keyword(s):  
Avascular Necrosis ◽  
Closed Reduction ◽  
Screening Method ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Range Of Movement ◽  
Cast Immobilization ◽  
Recommended Treatment ◽  
Dysplasia Of The Hip

Introduction: Besides an effective screening method for developmental dysplasia of the hip, there is certain number of children in whom the condition has been overseen or they have never been screened and the parents have noticed the odd walking pattern in their toddler. Treatment of such patients is controversial. One of the recommended treatment methods because of the short-term hospitalization, but often considered unsuccessful is closed reduction of the hip followed by cast immobilization. Hypothesis: Closed hip reduction in late diagnosed developmental dysplasia of the hip gives good results.&nbsp; Aim: Our aim in this retrospective study was evaluation of the success of the treatment with closed reduction of hip dislocation in children older than 12 months.&nbsp; Patients and methods: In the study, we included 20 patients treated at our clinic from June 2004 to May 2017. Of these 20 patients, 8 had bilateral involvement, 12 had unilateral, in a total of 28 hips. In all patients we noted preoperatively the range of movement, the presence of limp, any limb inequality, and hip pain. We used clinical and radiological parameters for evaluation. Clinically, we examined the range of movement, limb inequality as well as limb function and we classified it according to the modified McKay&rsquo;s criteria. Same examinations were done at 1, 3, and 5 years after closed reduction. Results: At the last follow-up examination, using McKey&rsquo;s criteria for clinical evaluation we rated the hips in two patients (7%) as grade III, i.e. fair grade, 10 hips (36%) were grade II &ndash; rated good, and 16 hips (57%) were evaluated as grade I. In four hips, there were signs of avascular necrosis of the hip, while in one patient the avascular necrosis developed after the closed reduction. Radiographic assessment (Figs 3, 4) using Severin&rsquo;s scoring system showed no hips with types V and VI, type IV was observed in 7%, type III in 21%, type II in 29%, while most of the hips (12, 43%) were type I. Conclusion: We concluded that the procedure was justified. An advantage of this method is that it is inexpensive; it entails no direct operative changes of the bone structures and gives good results.

scholarly journals Self-reported knowledge of national guidelines for clinical screening for hip dysplasia: a web-based survey of midwives and general practitioners in Denmark

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0068
Author(s):  
Hans-Christen Husum ◽  
Rikke Damkjær Maimburg ◽  
Søren Kold ◽  
Janus Laust Thomsen ◽  
Ole Rahbek
Keyword(s):  
General Practitioners ◽  
Correct Answer ◽  
Screening Program ◽  
Developmental Dysplasia ◽  
Further Education ◽  
Survey Study ◽  
National Guidelines ◽  
Web Based ◽  
Hip Abduction ◽  
Dysplasia Of The Hip

BackgroundThe positive predictive value of clinical hip examinations performed by generalist health professionals in screening for developmental dysplasia of the hip (DDH) is low.AimTo assess the self-reported recognition of nationally recommended clinical hip examinations in the screening programme for DDH in Denmark among midwives, general practitioners (GPs), and GPs in training.Design & settingA web based open survey study among Danish midwives, GPs and GPs in trainingMethodRespondents were asked to identify which of six written statements of clinical hip examinations were featured in the national Danish guidelines on DDH screening. Three statements were the official statements of the Ortolani, Galeazzi, and hip abduction examinations from the national guidelines and three statements were false and constructed by the author group. Participants were asked to select up to six statements.ResultsA total of 178 (58 GPs, 97 midwives and 23 GPs in training) responses were included.Eighty-nine per cent of responders correctly identified the Ortolani manoeuvre and 92% correctly identified one of the constructed descriptions as being false. The remaining four descriptions had significantly lower correct answer percentages ranging from 41% to 58% with significantly lower correct answer percentages of midwives for three out of all six descriptions when compared to GPs.ConclusionWe conclude that the recognition of two out of three recommended clinical hip examinations in the Danish screening program for DDH is overall low among current screeners. Efforts should be made to heighten the knowledge level by further education of screeners.

scholarly journals Results of hip resurfacing for developmental dysplasia of the hip of Crowe type I and II

2008 ◽  
Vol 121 (15) ◽  
pp. 1379-1383 ◽  
Author(s):  
Wei-dong XU ◽  
Jia LI ◽  
Zhen-hua ZHOU ◽  
Yue-song WU ◽  
Ming LI
Keyword(s):  
Hip Resurfacing ◽  
Developmental Dysplasia ◽  
Type I ◽  
Dysplasia Of The Hip

scholarly journals Relations between the Crowe classification and the 3D femoral head displacement in patients with developmental dysplasia of the hip

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Rongshan Cheng ◽  
Henghui Zhang ◽  
Willem Alexander Kernkamp ◽  
Jingmao Zheng ◽  
Kerong Dai ◽  
...  
Keyword(s):  
Femoral Head ◽  
Coordinate System ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Type I ◽  
Control Subjects ◽  
Head Displacement ◽  
Healthy Control ◽  
Crowe Classification ◽  
Dysplasia Of The Hip

Abstract Background The purpose of this study was to investigate the relationship between the three dimensional (3D) femoral head displacement in patients with developmental dysplasia of the hip (DDH) and Crowe classification. Methods Retrospectively, CT scans of 60 DDH patients and 55 healthy demography-matched healthy control subjects were analyzed. Using the anterior pelvic plane a pelvic anatomic coordinate system was established. The center coordinates of the femoral heads of both the DDH patients and control subjects were quantified relative to the pelvic coordinate system and were mapped proportionally to a representative normal pelvis for comparison. Results In the anteroposterior (AP) direction, the center of the femoral head was significantly more anterior in the DDH patients (type I, II, and III, respectively45.0 ± 5.5, 42.9 ± 7.1, and 43.9 ± 4.6 mm) when compared to the controls (50.0 ± 5.2 mm) (p < 0.001 for all). In the medial-lateral (ML) direction, the center of the femoral head was significantly more lateral in the DDH patients (type I, II, and III =103.5 ± 8.6, 101.5 ± 6.6, 102.1 ± 11.2 mm) when compared to the controls (87.5 ± 5.1 mm) (p < 0.001 for all). In the superior-inferior (SI) direction, the center of the femoral head was significantly more proximal in the DDH patients (type I, II, and III =62.4 ± 7.3, 50.0 ± 6.3, and 43.2 ± 6.6 mm) when compared to the controls (66.0 ± 6.2 mm) (p < 0.001 for all). Conclusions The severity of DDH using the Crowe classification was related to the degree of the femoral head displacement in the SI direction, but not in the ML or AP directions. By assessing the 3D femoral head displacement in DDH patients, individualized component positioning might benefit surgical outcome.

scholarly journals The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongshan Cheng ◽  
Muyin Huang ◽  
Willem Alexander Kernkamp ◽  
Huiwu Li ◽  
Zhenan Zhu ◽  
...  
Keyword(s):  
Pelvic Incidence ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Type I ◽  
Type Ii ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Background The purpose of this study was to investigate the association between the severity of Developmental dysplasia of the hip (DDH) and the abnormality in pelvic incidence (PI). Methods This was a retrospective study analyzing 53 DDH patients and 53 non-DDH age-matched controls. Computed tomography images were used to construct three-dimensional pelvic model. The Crowe classification was used to classify the severity of DDH. The midpoint of the femoral head centers and sacral endplates were projected to the sagittal plane of the pelvis. The PI was defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting this point to the axis of the femoral heads. Independent sample t-tests were used to compare the differences between the PI of DDH group and the non-DDH controls group. Kendall’s coefficient of concordance was used to determine the correlation between the severity of DDH and PI. Results Patients with DDH had a significantly (p = 0.041) higher PI than the non-DDH controls (DDH 47.6 ± 8.2°, normal 44.2 ± 8.8°). Crowe type I patients had a significantly (p = 0.038) higher PI (48.2 ± 7.6°) than the non-DDH controls. No significant difference between the PI in Crowe type II or III patients and the PI in non-DDH controls were found (Crowe type II, 50.2 ± 9.6°, p = 0.073; Crowe type III, 43.8 ± 7.2°, p = 0.930). No correlation was found between the severity of DDH and the PI (r = 0.091, p = 0.222). Conclusions No correlation was found between the severity of DDH and the PI. The study confirmed that the PI in DDH (Crowe type I) group was higher than that of the non-DDH control group, while the PI does not correlate with the severity of DDH.

scholarly journals Tübingen hip flexion splints for developmental dysplasia of the hip in infants aged 0–6 months

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
You Zhou ◽  
Rong Li ◽  
Chuan Li ◽  
Ping Zhou ◽  
Yan Li ◽  
...  
Keyword(s):  
Developmental Dysplasia ◽  
Hip Flexion ◽  
Dysplasia Of The Hip

scholarly journals Universal or selective ultrasound screening for developmental dysplasia of the hip? A discussion of the key issues

2018 ◽  
Vol 12 (4) ◽  
pp. 296-301 ◽  
Author(s):  
R. Biedermann ◽  
D. M. Eastwood
Keyword(s):  
Late Presentation ◽  
Developmental Dysplasia ◽  
Ultrasound Screening ◽  
Reduction Techniques ◽  
Alternative Outcome ◽  
Operation Rate ◽  
Hip Abduction ◽  
Recent Developments ◽  
Zero Rate ◽  
Dysplasia Of The Hip

Purpose To summarize recent developments and provide recommendations as to whether universal or selective programmes are advisable. Methods A literature review was performed and preference given to studies with higher levels of evidence. All programmes reviewed included clinical screening. Results Recent studies underline the need for high quality screening programmes to promote the early detection of developmental dysplasia of the hip (DDH). A small number of cases may be missed clinically but with universal ultrasound screening programmes the late presentation rates appear to be virtually zero. Contemporary studies show treatment rates with universal screening programmes which are now lower than those with selective ultrasound. There is little agreement over the criteria used for selective programmes. Alternative outcome measures, such as the first operation rate or the percentage undergoing major (open) surgery are both lowest with universal ultrasound screening programmes. Furthermore, a significant reduction in the rate of surgery for DDH later in life was seen after the introduction of universal ultrasound screening, whereas the defined criteria for selective screening may not detect the majority of patients who require late surgery. Abduction bracing with modern orthoses is associated with a zero rate of avascular necrosis (AVN), whereas closed reduction techniques have an overall risk of 10%. Conclusion On clinical grounds, if future studies confirm that hip abduction in flexible orthoses is not associated with AVN, it may be time for a paradigm shift of screening for DDH towards a universal ultrasound protocol. The costs associated both with each type of screening programme and with the management of late presenting cases are also important but may be secondary to clinical benefit.

scholarly journals There is No Link Between Birth Weight and Developmental Dysplasia of the Hip

2021 ◽  
Author(s):  
Charlotte Hanratty ◽  
Balamurugan Thyagarajan ◽  
Nicholas M. Clarke ◽  
Alexander Aarvold
Keyword(s):  
Birth Weight ◽  
Incomplete Data ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Future Research ◽  
High Birth Weight ◽  
Data Sets ◽  
Singleton Pregnancy ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Aims Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH. Patients and Methods This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS. Results There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, p = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent T test, p = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g (p < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH (p = 0.068), nor between males with and without DDH (p = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed (p = 0.543), nor according to breech presentation (p = 0.8). Longer gestation babies weighed more (p < 0.00001), yet showed no increase in DDH incidence (p = 0.64). Conclusion This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.

Sign in / Sign up

Export Citation Format

Share Document