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Dysplasia of hip development: update. Aproximadamente um em cada 1. The term "Developmental Dysplasia of the Hip - DDH" includes a wide spectrum of abnormalities in the immature hip, ranging range from subtle dysplasia to joint dislocation. The incidence of DDH is variable, and depends on a number of factors, such as geographical location.
Approximately one in 1, newborn infants may present hip dislocation and 10 in 1, present hip instability. Brazil has an incidence of five per 1, in terms of the positive Ortolani signal, which is the early clinical signal for detecting the disorder. The risk factors for DDH include: female sex, Caucasian race, first labor, young mother, breech presentation on birth, family history, oligohydramnios , newborn with higher weight and height, and deformities of the feet or spine.
Hip examination of the newborn should be routine, and should be emphasized in maternity units. In newborn infants and babies, the diagnosis of DDH is preeminently clinical and is carried out using the Ortolani and Barlow maneuvers. Conventional X-ray is of limited value for confirming the diagnosis of DDH in the newborn infant, and ultrasound of the hip is the ideal exam. The treatment of DDH is challenging, both for the pediatric orthopedist and for the general practitioner.
The objectives of the treatment include early diagnosis, reduction of the articulation, and stabilization of the hip in a secure position. Classically, treatment options are divided according to the different age groups, at the time of diagnosis. Development dysplasia of the hip from birth to six months. J Am Acad Orthop Surg. Acta Ortop Bras.
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Staheli LT. Porto Alegre: Artmed; Staying out of trouble in pediatric orthopaedics. Am Fam Physician. Clinical screening for developmental dysplasia of the hip in Northern Ireland. Cole WG. Evaluation of a teaching model for the early diagnosis of congenital dislocation of the hip. J Pediatr Orthop. Sernik R. Ultrassonografia do sistema musculoesqueletico.
Rio de Janeiro: Revinter; Role of ultrasound in the diagnosis and management of developmental dysplasia of the hip: an international perspective. Orthop Clin North Am. Ultrasound in the early diagnosis of congenital hip dislocation. Pavlik A. The functional method of treatment using a harness with stirrups as the primary method of conservative therapy for infants with congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life.
J Bone Joint Surg Am. Kalamchi A, MacFarlane R 3rd. The Pavlik harness: results in patients over three months of age. Avascular necrosis following treatment of congenital dislocation of the hip. Developmental dysplasia of the hip from six months to four years of age. Treatment of developmental dysplasia of the hip after walking age with open reduction, femoral shortening, and acetabular osteotomy. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License.
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Dolor de cadera. El síndrome de pinzamiento femoroacetabular