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Lecture 1

HHD5188 Lecture Notes - Lecture 1: Birth Order, Flat Feet, Toe Walking


Department
HHD
Course Code
HHD5188
Professor
All
Lecture
1

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Failure to develop normally
Requires well seated femoral head
Developmental dysplasia of the hip
Spherical socket with no deficiencies in the acetabulum
Normal hip
Will lead to Early hip OA is missed Dx
First born child more at risk
Female
Breech presentation
Birth order
Px
Oligohydramnios
Large baby
Packaging problems
Pregnancy problems
First degree relative
FHx
Ask
Timing
Warm well fed and relaxed baby
Exposure
Gen appearance
Head, neck and spine
Skin creases
Thigh length (Galeazzi test)
Abduction range
Look
For instability
Hip at 90 degree flexion
adducted
Barlow test (B for push back)
Ortolani test (bottom)
Feel
Decreased hip abduction
Assymetric skin folds (not reliable sign)
Galeazzi sign
How to identify DDH?
for > 6 weeks upto 7months old
Should not replace clinical exam
U/S
Ix
e.g. pavlik harness
4/52 trial to relocate a dislocated/sublaxted hip
Brace treatment
Mx
How do I find dysplasia
Its normal to have bowing up til age of 3
Assymetrical is abmormal
Bow legs "Genu Varum"
Classic Px's we should know
Pediatric orthopedics
Wednesday, 29 May 2013
1:04 PM
pediatrics term Page 1
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