Hip joint development in children with type IIb developmental dysplasia

Sibiński, Marcin; Adamczyk, Emil; Higgs, Z.; Synder, Marek

doi:10.1007/s00264-011-1447-8

Cited by 13 publications

(15 citation statements)

References 16 publications

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“…12,13 Despite newborn screening and early treatment approaches, as a rare event, DDH may be encountered in older children particularly in developing countries. 14,15 In such late unilateral or bilateral cases, conservative approach is not recommended, and direct surgical interventions are emphasized as a necessity. 16 In studies examining the demographic characteristics of DDH, female gender has been reported as a risk factor.…”

Section: Discussionmentioning

confidence: 99%

What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

Donma

Doğru

Demirkol

et al. 2017

JCS

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Developmental dysplasia of the hip (DDH) is an important cause of childhood disability. Subluxation or dislocation can be diagnosed through pediatric physical examination; nevertheless, the ultrasonographic examination is necessary in diagnosing certain borderline cases. It has been evaluated routine sonographic examination of 2,444 hips of 1,222 babies to determine differences in both, developmental dysplasia and types of hips, and evaluated their development on the 3-month follow-up. Evaluating the pathologic "α" angles under 59, there was no statistically significant differences between girls and boys in both right (55.57 AE 3.73) (56.20 AE 4.01), (p ¼ 0.480), and left (55.79 AE 3.96) (57.00 AE 3.84), (p ¼ 0.160) hips on the 45th day of life. Routine sonographic examinations on the 45th day of life revealed that 51 of (66.2%) 77 type 2a right hips were girls and 26 (33.8%) were boys. The number of the right hips that develop into type 1 was 38 (74.5%) for girls and 26 (100%) for boys on the 90th day of life (p ¼ 0.005). A total of 87 type 2a left hips included 64 girls (73.6%) and 23 boys (26.4%). In the 90th day control, 49 right hip of girls (76.6%) and 21 right hip of boys (91.3%) developed into type 1 (p ¼ 0.126). In the assessment of both left and right hips, girls showed a significantly higher frequency in latency and boys showed significantly higher development in the control sonography. A total of 31 girls (2.5%) and 11 boys (0.9%) accounted for a total of 42 (3.4%) cases who showed bilateral type 2a hips in 1,222 infants. On the 90th day control, 26 girls (83.9%) and all 11 boys (100%) developed into type 1 (p ¼ 0.156). The study emphasizes the importance of the sonographic examination on the 90th day of life. Results of the investigation include the data of sonographic screening of DDH on the 45th day, and also stress the importance of the 90th-day control sonography after a close follow-up with physical examination between 45th and 90th days of life.

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Section: Discussionmentioning

confidence: 99%

What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

Donma

Doğru

Demirkol

et al. 2017

JCS

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“…The 2 0 angle difference may exert a major repercussion on borderline hips: type IIa-, IIa+ or IIb with alpha angle value close to 60 0 . This category of patients is the main cause for controversial literature data on the increased rate of over-diagnosis [6,12,18,19].…”

Section: Discussionmentioning

confidence: 99%

A new sign in the standard hip ultrasound image of the Graf method.

et al. 2015

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Aim: The aim of the study was to assess the usefulness of obtaining a 90 0 angle between the plane of the osteochondral plate and the surface of the transducer during standard hip ultrasonography according to Graf method. Material and methods: In this retrospective study 1078 patients (2156 hips) were included examined between 2008 and 2014 for developmental dysplasia of the hip (DDH) ultrasound screening. The patients were divided in two groups. Group I consisted of 402 patients examined between January 2008 and December 2011 using the standard Graf method. Group II consisted of 676 patients examined from January 2012 to December 2014 using the Graf method with an additional criterion: 90 0 angle between the plane of the osteochondral plate and the surface of the transducer. Results: We found more dysplastic patients in group I comparing to group II: 55 (13.7%) and 38 (5.6%) respectively. The difference in the incidence of patients diagnosed with DDH was highly significant (p<0.001). The mean alpha angle value in group I was 65.31 0 , respectively 67.52 0 for group II (p<0.001). Conclusion: The new osteochondral plate sign has the potential to reduce the overdiagnosis of DDH and provide a better tailored approach to borderline hips.

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“…Fig. 2 Patient's X-rays-upper row representing preoperative state and state after bloody reposition, lower row shows pre-operative state and after operative treatment using an anterior approach As part of the pre-operative state, all patients underwent clinical examination, hip ultrasound and radiographic diagnostic and none of the patients underwent artrography during preparation state for the surgery [12,13]. The data analysis includes the state at the beginning of the treatment, the postoperative state, the state at discharge and control findings where we followed the development of the proximal femoral part up to 72 months on average.…”

Section: Methodsmentioning

confidence: 99%

Operative treatment and avascular necrosis of the hip development disorder

Gavrankapetanović

Hadžimehmedagić

Papović

et al. 2014

International Orthopaedics (SICOT)

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Purpose The purpose of this research was (1) to evaluate the consequences of an operative treatment of hip developmental disorder in children, (2) to evaluate the significance of hip vascular supply in children through indirect radiological signs, such as morphological changes on femoral head, and to classify them with standard classification methods, and (3) to analyse the research results and make a recommendation for the following treatment dilemma: when is the optimal time for an operative treatment of a hip development disorder? Methods The research is a retrospective and observational analysis based on the classification of indirect radiological signs of local vascular disorder by the Bucholz-Ogden's scale. Materials used for this research are medical records of treated patients at the Clinic for Orthopaedics and Traumatology of the Sarajevo University Clinical Centre. Using a random selection, two groups of 30 patients with hip development disorder were formed. The first group was comprised of patients aged six to 18 months and the second group of patients aged 18-60 months. The medical records used for this research included all necessary anamnestic details and postoperative state treatments with clinical findings and regular radiological check-up findings that include the presence or absence of the ossification nucleus as well as its position. All patients underwent surgery with the same operative technique. Data analysis points include the state at the beginning of the treatment, the postoperative state, the state at discharge as well as control findings that followed the development of the proximal femoral part up to 72 months on average. The analysis covered data such as age, sex, family anamnestic data, clinical findings and radiological findings regarding the femoral head morphology (appearance, size, shape, position and indirect signs showing lack of vascular supply). In addition, data analysis included the types of any previous conservative or operative treatments, the duration of previous conservative treatments and repeated hospitalization. Results In group 1, 86.6 % were female patients and 80 % in group 2. Family history was positive in 15.6 % in group 1 and 13.3 % in group 2. A total of 51.6 % of all patients started walking on time, while the rest had problems with verticalization. Of all patients, 47 % did not undergo any kind of prior treatment. Only 62.2 % of group 1 patients had ossification nucleus present, while the entire group 2 had it present. Results showed that 24.32 % of group 1 patients had none or minimal signs of avascular necrosis (AVN) while 39.47 % of group 2 had none or minimal signs of AVN; 60.52 % of group 2 patients had signs of AVN. Conclusion The results of this study show that the performance of a surgical treatment during the age between 12 and 20 months is burdened by the highest percentage of avascular necrosis. Even though AVN can be noticed in other age groups, according to the results of our research, it seems that vascular supply of the hip is the mos...

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Hip joint development in children with type IIb developmental dysplasia

Abstract: Despite obtaining normal sonograms at the end of treatment, some children with type IIb dysplasia may demonstrate radiographic evidence of persistent hip dysplasia over a longer follow-up period. Our results suggest that these children should be monitored until skeletal maturity.

Cited by 13 publications

References 16 publications

What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

A new sign in the standard hip ultrasound image of the Graf method.

Operative treatment and avascular necrosis of the hip development disorder

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