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[Developmental dysplasia of the hip in children with a psychomotor disorder. A risk factor for a poor outcome?]

Iván Pipa-Muñiz1, María de Los Llanos Rodríguez-Rodríguez2, M Blanca Felgueroso-Juliana3

  • 1Servicio de COT, Hospital de Cabueñes, Gijón, Asturias, España.

Anales De Pediatria (Barcelona, Spain : 2003)
|September 12, 2015
PubMed

Insights

Cerebral impairment significantly worsens outcomes for developmental dysplasia of the hip (DDH) treatment, increasing poor outcome risk by 7.2 times. Delayed walking in DDH patients warrants neurological assessment.

Area of Science:

  • Orthopaedics
  • Paediatric Neurology
  • Developmental Paediatrics

Background:

  • Early diagnosis of developmental dysplasia of the hip (DDH) typically leads to successful orthopaedic treatment.
  • Outcomes for DDH patients with co-occurring cerebral impairment are not well-established.
  • Cerebral impairment may impact the success of DDH treatment.

Purpose of the Study:

  • To investigate the outcomes of developmental dysplasia of the hip (DDH) treatment in patients with cerebral impairment.
  • To determine the impact of neurological disorders on DDH treatment success.

Main Methods:

  • Retrospective observational study of 325 DDH cases (293 patients).
  • Inclusion of patients with poor orthopaedic treatment outcomes and unknown psychomotor status.
  • Clinical, radiological, and neurological assessments by a Child Neurology Unit.

Main Results:

  • 10 patients (3%) with DDH also had cerebral impairment.
  • Orthopaedic treatment success was only 25% (4/16 hips); 12 hips required surgery.
  • Surgical treatment improved Acetabular Index (p=0.005) and Reimers Extrusion Index (p=0.042).
  • Cerebral impairment diagnosed at 2.5 years; delayed walking noted at 2.4 years.

Conclusions:

  • Cerebral impairment is associated with a 7.2 times higher relative risk of poor DDH treatment outcomes.
  • Unfavourable DDH outcomes should prompt suspicion of neurological disorders, especially with delayed walking.
  • Early identification of neurological issues is crucial for managing DDH patients.
Abstract

Keywords:
Cerebral impairmentCerebral palsyDevelopmental dysplasia of the hipDisplasia del desarrollo de la caderaParálisis cerebral infantilTrastorno psicomotor

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