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Voluntary hip dislocation in Down's syndrome: report of two cases
S Turra1, C Gigante, C Iacobellis
1Divisione di Ortopedia Ospedale Civile di Treviso.
La Chirurgia Degli Organi Di Movimento
|April 1, 1995
Summary
This study reports two cases of voluntary hip dislocation in Down syndrome, observing natural joint changes without surgery. Early surgical intervention is suggested to prevent progressive subluxation and fixed dislocation.
Area of Science:
- Orthopedics
- Genetics
- Developmental Biology
Background:
- Down syndrome is associated with joint laxity, increasing the risk of hip dislocations.
- Voluntary hip dislocation is a rare phenomenon, particularly in individuals with Down syndrome.
- Understanding the natural history of hip dislocation in this population is crucial for management.
Observation:
- Two cases of unilateral voluntary hip dislocation in children with Down syndrome were documented.
- Families declined surgical intervention, allowing observation of the natural progression of the condition.
- Imaging (CT scan) after one year showed initial smoothing of the posterior acetabular wall.
Findings:
- One case demonstrated progressive subluxation over nine years, culminating in a fixed dislocation.
- The untreated hip joint morphology evolved significantly, indicating progressive instability.
- These findings highlight the detrimental long-term effects of untreated hip dislocation.
Implications:
- Early surgical management is critical to prevent irreversible joint damage and fixed dislocation in Down syndrome patients.
- This study underscores the importance of timely orthopedic interventions for hip instability in this demographic.
- Further research into optimal surgical timing and techniques is warranted.