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Plagiocephaly after Neonatal Developmental Dysplasia of the Hip at School Age
A Marita Valkama1,2,3, Henri I Aarnivala1,2,3, Koshi Sato3,4
1Department of Children and Adolescents, Oulu University Hospital, 90029 Oulu, Finland.
Insights
Infants treated for developmental dysplasia of the hip (DDH) may develop plagiocephaly and malocclusions. Early intervention for hip dysplasia requires monitoring for associated cranial and dental issues in childhood.
Area of Science:
- Orthopedics
- Pediatric Health
- Craniofacial Development
Background:
- Developmental dysplasia of the hip (DDH) treatment often involves supine positioning for infants.
- Supine positioning is a known risk factor for deformational plagiocephaly.
- The long-term effects of DDH treatment on craniofacial development require further investigation.
Purpose of the Study:
- To assess the prevalence of plagiocephaly and malocclusions in school-aged children previously treated for DDH in infancy.
- To determine if early DDH treatment is associated with cranial asymmetries and dental malocclusions.
Main Methods:
- Retrospective cohort study comparing school-aged children treated for DDH with a control group.
- Plagiocephaly assessment using anthropometric measurements (cephalic index, oblique cranial length ratio) from 2D vertex photographs.
- Malocclusion assessment, specifically crossbite, was also recorded.
Main Results:
- Plagiocephaly was significantly more prevalent in children treated for DDH (10.3%) compared to controls (1.6%) (p=0.041).
- Crossbite prevalence was higher in the DDH group (24.1%) than in the control group (10.3%).
- These findings indicate a significant association between infant DDH treatment and later cranial asymmetries and malocclusions.
Conclusions:
- Infant DDH treatment is associated with an increased risk of developing plagiocephaly and malocclusions by school age.
- Preventive strategies and monitoring for craniofacial development should be considered in infants undergoing DDH treatment.
- Further research is warranted to elucidate the underlying mechanisms and optimize management protocols.
Abstract:
Developmental dysplasia of the hip (DDH) may require early abduction treatment with infants sleeping on their back for the first few months of life. As sleeping on back is known to cause deformational plagiocephaly, we assessed school age children treated for dislocation or subluxation of the hip-joint in infancy. Plagiocephaly was analyzed by using cephalic index (CI) and oblique cranial length ratio (OCLR) as anthropometric measurements from 2D digital vertex view photographs. Six of the 58 (10.3%) DDH children and only one of the 62 (1.6%) control children had plagiocephaly (p = 0.041). Furthermore, cross bite was found in 14 (24.1%) of the DDH children and in 7 (10.3%) of the control children. Developmental dysplasia of the hip in infancy was associated with cranial asymmetries and malocclusions at school age. Preventive measures should be implemented.
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