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"Video Technique on Clinical Tests for DDH": New-Born to Walking Age
Atul Bhaskar1, Chintan Doshi1, Taral Nagda1
1Children Orthopaedic Surgical Services, Apt 3/Bldg No 18, Mhada Complex, Oshiwara Link Road, Mumbai, 400053 India.
Insights
Early diagnosis of developmental Dysplasia of Hip (DDH) is crucial. Recognizing subtle signs like limb asymmetry and restricted hip movement in infants and children aids in timely detection and intervention.
Area of Science:
- Pediatrics
- Orthopedics
- Developmental Biology
Background:
- Developmental Dysplasia of Hip (DDH) diagnosis often remains challenging.
- Early detection requires heightened awareness of subtle clinical signs.
- Asymptomatic presentations necessitate astute clinical examinations.
Purpose of the Study:
- To highlight key clinical signs of DDH for early identification.
- To emphasize the importance of routine hip examinations in newborns.
- To guide clinicians in recognizing subtle indicators of hip dysplasia.
Main Methods:
- Review of clinical examination techniques for hip instability.
- Description of physical signs associated with DDH in infants and children.
- Emphasis on Barlow and Ortolani tests for newborn screening.
Main Results:
- Newborns require examination for hip instability using Barlow and Ortolani tests.
- Limb length discrepancy, restricted hip abduction, and crease asymmetry are key indicators.
- Limp, positive Trendelenburg sign, waddling gait, and lumbar lordosis suggest DDH in older children.
Conclusions:
- Clinicians must be proficient in identifying early signs of DDH.
- Ignoring subtle signs can lead to late-presenting DDH.
- Comprehensive clinical examination is vital for preventing long-term complications of DDH.
Introduction:
The early diagnosis of developmental Dysplasia of Hip (DDH) remains elusive. In the absence of symptoms, early signs need heightened awareness and an astute clinical examination.
Clinical Tests:
Every newborn child must be examined for hip instability by the Barlow and Ortolani tests. Periodic examination of the lower limbs for limb length discrepancy, restricted hip abduction, thigh or gluteal crease asymmetry must alert the examiner to rule out hip dysplasia. In a walking child with unilateral DDH the limp is obvious, and the Trendelenburg sign is positive. In bilateral DDH, limitation of hip abduction and waddling gait with increased lumbar lordosis are the only early discernible signs. Often the care-giver or parents notice the subtle changes of limb asymmetry and bring to the notice of the primary care doctors. These early signs must not be ignored to prevent late presenting DDH.
Conclusion:
This article highlights the signs of DDH that every clinician dealing with children must be well-versed.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s43465-021-00528-w.
