Developmental dysplasia of hip: Difference between revisions

(Text replacement - "Category:Peds" to "Category:Pediatrics")
(Text replacement - " pts" to " patients")
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==Management==
==Management==
*Refer ALL pts to pediatric orthopedist
*Refer ALL patients to pediatric orthopedist
*0-6 mo Pavlik harness or spica
*0-6 mo Pavlik harness or spica
*Older=ORIF
*Older=ORIF

Revision as of 16:50, 21 June 2016

Background

  • D/t abnormal relationship of fem head to acetabulum, usu in o/w healthy infants prior to or shortly after birth
  • <2% incidence
  • 4-6X more common in girls

Clinical Features

  • Early: see asymm soft tissue folds in groin, buttock & thigh, limb may be pulled prox & short
  • Ortolani on ALL young inf in ED, flex hip & knee @ 90 degrees & the thigh is abducted, the lateral aspect of both thighs should touch the table, the dislocated side will be restricted & have "click" as head slips out of acetabulum
    • by 6 wk <30% will have + ortolani or bartlow

Differential Diagnosis

Pediatric hip pain

Diagnosis

  • <3mo: Utz hip
  • >3mo: AP pelvis with both legs extended in neutral abduction
  • Shenton's line
  • Acetabular angle should be <30'

Management

  • Refer ALL patients to pediatric orthopedist
  • 0-6 mo Pavlik harness or spica
  • Older=ORIF

Disposition

See Also

References