Dysplasia of the Hip

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Dysplasia of the Hip

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The theme of this page is beyond the scope of the mission of I.B.I.S. The links shown below are highly selected and of limited scope.

Hip Dislocation
Hip Dysplasia
Hip Luxation
Hip Subluxation

A Selection of Internet Sites

[*] Outstanding
[P] For Professionals
[Ukrainian]

[*] [P] Screening for Developmental Dysplasia of the Hip
by Linda M. French, M.D. - et al, Oakwood Healthcare System, Dearborn, Michigan. American Academy of Family Physicians. Screening programs relying primarily on physical examination techniques for the early detection and treatment of congenital hip abnormalities have not been as consistently successful as expected ... The natural history of developmental dysplasia of the hip is not completely understood ... A more recent British study employing universal ultrasound examination of the hips in 14,050 newborns found that 90 percent of ultrasonographic abnormalities normalized spontaneously without treatment and that no infants with ultrasonographically normal hips at birth presented later with dislocations ... Ortolani and Barlow Maneuvers: The Ortolani and Barlow maneuvers have been the standard techniques for detecting hip instability in newborns9 (Figure 1). These maneuvers cannot be performed in a fussy, crying infant whose muscle activity may inhibit the movement of an unstable hip. For the examinations, the infant's hips are flexed to 90 degrees; the thumbs of the examiner are placed on the medial proximal thigh, and the long fingers are placed over the greater trochanter. For the Ortolani maneuver, the contralateral hip is held still while the thigh of the hip being tested is abducted and gently pulled anteriorly. The sensation of instability in a positive Ortolani maneuver is the palpable and sometimes audible "clunk" of the femoral head moving over the posterior rim of the acetabulum and relocating in the cavity ... Ortolani maneuver must be performed very gently to avoid obscuring the sound of the femoral head passing over a poorly developed posterior acetabulum ... The Barlow maneuver is performed by adducting the hip while pushing the thigh posteriorly ... Other investigators have popularized ... real-time ultrasonography to visualize the hips during physical examination ... Some concerns have been raised about the reliability of ultrasonographic imaging of the infant hip ...

Congenital Hip Dislocation (Infantile Hip Dislocation) (Congenital Dislocation of the Hip) (CD) (Developmental Dysplasia of the Hip) (DDH)
Michael P. D'Alessandro, M.D., Children's Virtual Hospital. The Ortolani/Barlow maneuver is used in which you attempt dislocation of the flexed hip by abduction of the proximal femur producing a click on posterior dislocation and another as the femoral head slides back into the acetabulum with adduction. Seen in 0.25-0.85% of newborns with a female to male predominance of 8:1. Most are unilateral and usually are on the left ...

Developmental dysplasia of the hip
Congenital hip dislocation ... females (80-90%) ... white > blacks ... associated: breech delivery, C-section, torticolis, family history ... LEFT (70%); bilateral in only 5% ... Putti's triad - supero-lateral migration of femoral head, increased acetabular angle, small capital femoral epiphysis.

Education Modules
Alfred I. duPont Institute of The Nemours Foundation Wilmington, Delaware ... General Medical ... General Orthopaedist ... Pediatric Orthopaedist ...

Developmental Dysplasia of the Hip
The term developmental dysplasia of the hip (DDH) is general and encompasses the many facets of the condition. DDH is variable at presentation but is defined as an abnormal formation of the hip joint occurring between organogenesis and maturity as a result of instability. It is intentionally nonspecific to include the entire spectrum in both time (age) and severity ... The change from congenital to developmental is crucial because clear evidence has shown that not all cases are diagnosable at birth. Hips that are found normal at birth (an even in the first months of life) can subsequently be found to be abnormal later ... In general, the incidence in white neonates is 1.0% for dysplasia, and 0.1% for dislocated hips. Incidence varies with race. There is an increased incidence in native American populations, and a decrease incidence in the black, Korean, and Chinese populations. There is a fourfold increased likelihood in females, and the left side is involved in 60% of cases (right 20%, bilateral 20%). Associated birth factors include breech presentation, torticollis, talipes equinovarus, metatarsus adductus, and being first born. These factors are believed to be "packaging issues" ...

[Ukrainian] Hip Dislocation
Fact Sheet for Parents in Ukrainian
Description ... Causes ... Features and symptoms ... Diagnosis ... Complications ... Treatment

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21/July/2002 sl