DDH_Presentation congenital dislocation.pptx

Development dysplasia of hip detailed presentation

1. Developmental Dysplasia of the Hip (DDH) Pediatrics – Orthopaedics Presentation

2. Introduction Developmental Dysplasia of the Hip (DDH) refers to abnormal development of the hip joint. Spectrum: acetabular dysplasia, subluxation, dislocation.

3. Epidemiology & Risk Factors Incidence: 1–2 per 1000 live births. Female > Male (6:1). Breech presentation, first-born, oligohydramnios. Family history increases risk.

4. Pathoanatomy Shallow acetabulum with insufficient femoral head coverage. Labrum hypertrophy and intra-articular changes in chronic cases. Soft tissue contractures contribute to instability.

5. Clinical Features Neonates: Ortolani and Barlow tests. Limited hip abduction, leg length discrepancy (Galeazzi sign). Older children: limp, Trendelenburg gait.

6. Imaging Ultrasound: preferred in infants <6 months. Graf classification for hip dysplasia. X-ray: useful after 6 months (Shenton’s line, acetabular index).

7. Management – By Age 0–6 months: Pavlik harness (dynamic abduction orthosis). 6–18 months: Closed reduction + spica casting. >18 months: Open reduction ± femoral/pelvic osteotomy.

8. Complications Avascular necrosis of femoral head. Residual acetabular dysplasia. Recurrent dislocation. Early osteoarthritis.

9. Summary Early detection critical for optimal outcomes. Screening includes physical exam and selective ultrasound. Treatment varies with age at diagnosis. Goal: stable, concentric reduction of hip joint.