VALUE OF THE FIRST EXAMINATION FOR DEVELOPMENTAL DYSPLASIA OF THE HIP - OUR EXPERIENCES
Journal Title: Acta Facultatis Medicae Naissensis - Year 2012, Vol 29, Issue 3
Abstract
Developmental dysplasia of the hip (DDH) means a distinct dislocation (lateralisation and cranialisation) of the femoral head from the poorly developed (hypoplastic and steeper) acetabulum. The aim of the paper was to establish, in a retrospective and prospective study conducted in the period between January 1, 2006 and December 31, 2010, the total number and characteristics of instances of DDH in the first clinical and ultrasound examinations in newborns examined at the Traumatology Clinic of the Clinical Centre in Banja Luka. Six thousand one hundred thirty-two children were examined and 99 were treated. The percentage of girls among the treated children was considerably higher (96%). The ultrasound examination was performed first and was followed by the clinical examination. The ultrasound examination of all babies was performed with an electronic 5-12-MHz probe, using the standard Graf’s method. 7.8% of the cases, mostly primiparae, had a positive family history of DDH. The incidence diagnosed clinically amounted to 8.87%, and the incidence diagnosed by ultrasound to 1.61%. The first clinical examination diagnosed a limited abduction of the right hip in 12.1% of the newborns, while limited abduction of the left hip was present in 96.0%. Ortolani’s sign in the right hip was positive in 3.0% and in 33.3% patients it was positive in the left hip. 3.0% of the newborns had a positive Palmen sign in the right hip in the first examination, and 42.4% in the left. 3% of the patients had asymmetric skin creases on the right upper leg, while 87.9% of the patients had them on the left upper leg. 46.5% of the patients had crepitations in their right hip, while 83.8% had crepitations in the left hip. 2% of the patients had a lax right hip, while 3% had a lax left hip. The results obtained from the ossified acetabulum of the right hip in the examined sample were as follows: good in 91.9%, satisfactory in 5.1%, insufficient (deficient) in 2.0%, and bad in 1.0% of the cases. The results from the left ossified acetabulum were as follows: good in 3.0%, satisfactory in 44.4%, insufficient (deficient) in 45.5 %, bad in 7.1% of the cases. The bony protrusion - acetabular labrum on the right hip was angular in 90.9%, obtuse (fused) in 1.0%, round in 7.1%, round to flat and flat in 1.0% of the cases. The bony protrusion - acetabular labrum on the left hip was angular in 2.0 %, obtuse (fused) in 2.0%, round in 81.8%, round to flat and flat in 14.1% of the cases. It is important to commence with diagnosing and treating DDH as early as possible by applying atraumatic aids and procedures while all structures are elastic, reducible and adaptable. The clinical examination is unreliable in terms of diagnosis of DDH, but it is mandatory as a part of the full physical examination of a newborn baby.
Authors and Affiliations
Predrag Grubor, Milan Grubor, Marinko Domuzin, Ivan Golubović
Keywords
Related Articles
- EP ID EP147078
- DOI 10.2478/v10283-012-0017-3
- Views 89
- Downloads 0
Error Analysis for Determination of Accuracy of Johnson’s Formula, Dare’s Formula and Mother's Opinion for the Estimation of Birth Weight: Results of an Iranian Cross‐Sectional Study
Accurate fetal weight estimation is important for the management of birth. According to the existing literature, none of the clinical techniques is superior to any other. This study aimed to compare error analysis for th...
The Influence of Mg(II) and Ca(II) Ions on Rutin Autoxidation in Weakly Alkaline Aqueous Solutions
Rutin (quercetin-3-O-rutinoside) is one of the most abundant bioflavonoids with various biological and pharmacological activities. Considering the ubiquitous presence of Mg(II) and Ca(II) ions in biological systems we de...
Intracystic Papillary Carcinoma in a Male Breast: Thirty Years after Orchiectomy - - - Intracistični papilarni karcinom u dojci muškarca: trideset godina nakon orhiektomije
Papillary carcinoma of the breast is an extremely rare form of breast carcinoma in males. We report a case of an 83-year-old man who presented with a retroareolar palpable mass, associated with bloody nipple discharge. C...
PREOPERATIVE PREPARATION OF PATIENTS FOR GYNECOLOGIC SURGERY
Surgical treatment of the patients with gynecologic diseases is warranted only when all the conservative treatment approaches have been exhausted. Surgical treatment is a stress for the patient, and associated risks and...
Troponin and C-reactive Protein in Risk Stratification after Myocardial Infarction - - - Troponin i C-reaktivni proteini u stratifikaciji rizika nakon infarkta miokarda
The aim of this study was to investigate the prognostic significance of troponin I, C-reactive protein and risk factors for the occurrence of complications after myocardial infarction. Troponin I and C-reactive protein v...