The diagnosis and management of congenital dislocation of the hip
Clarke, N.M.P. and Sakthivel, K. (2008) The diagnosis and management of congenital dislocation of the hip. Paediatrics and Child Health, 18, (6), 268-271. (doi:10.1016/j.paed.2008.03.007).
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Congenital dislocation of the hip (CDH) or developmental dysplasia of the hip (DDH) is a common condition that encompasses a spectrum of pathology affecting the neonatal hip. Clinical signs of instability may be difficult to detect at birth using the Barlow Ortolani test. A clear imperative is to make an early diagnosis since delay after 3 months is synonymous with the necessity for surgery and also leads to a compromised prognosis. There is considerable controversy about clinical screening for DDH or ultrasound screening, either comprehensive or selective. Risk factors – such as breech presentation, oligohydramnios and talipes – are well known and there is some evidence that selective screening for these babies with ultrasound may assist diagnosis. The incidence of neonatal hip instability is around 15–20 per 1000 live births but that of established dislocation 1–2 per 1000 live births in unscreened cohorts. The usual early treatment is with the Pavlik harness but after 3 months, surgery – either an open or closed reduction – is necessary and in some surgically untreated children, secondary procedures such as pelvic osteotomy are necessary.
|Digital Object Identifier (DOI):||doi:10.1016/j.paed.2008.03.007|
|Additional Information:||Symposium: Surgery & orthopaedics|
|Keywords:||arthrogram, harness, hip dysplasia, osteotomy, screening programme|
|Subjects:||Q Science > QP Physiology
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
|Divisions :||University Structure - Pre August 2011 > School of Medicine > Developmental Origins of Health and Disease
|Accepted Date and Publication Date:||
|Date Deposited:||29 Sep 2008|
|Last Modified:||31 Mar 2016 12:43|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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