IDIOPATHIC DEVELOPMENTAL DYSPLASIA OF HIP – A DEMOGRAPHICAL STUDY

Abstract

Abstract

Objective:  The objective of this study was to record the demography of idiopathic developmen-tal dysplasia of hip and compare it with other sim-ilar studies reported in Pediatric Orthopaedic lite-rature.

Methodology:  Thirty patients attending outdoor,department of Pediatric Orthopedic Surgery, Chil-dren's Hospital and Institute of Child Health, Lahore, with idiopathic developmental dysplasia of hip were studied. Detailed histories of the patients were taken, thorough clinical examinations were done, ultrasono-graphy and radiological examinations of the hip were performed.All the patients were followed up till the treatment and demography of idiopathic developmen-tal dysplasia of hip was recorded.

Results:  In this demographical study of idiopathic developmental dysplasia of hip, age of presentation ranged from6months to 60 months withmedian age of 27 months. There were 24 (80%) females and 6 (20%) males with female to male ratio of4:1. Twelve (40%) were first born babies. Family history was positive in 18 (60%) patients. Left hip was affected in 10 (33.3%) patients and right hip was affected in 8 (26.6%) pati-ents. Twelve (40%) patients had bilateral involvement of hip joints. All the forty two affected hips of thirty patients had limited abduction. Barlow jerk of entry and Ortolani provocative test were negative. Ultra-sonographic and radiological signs of idiopathic deve-lopmental dysplasia of hip were positive in all the pati-ents. Among these thirty patients, 5 (16.67%) patients treated with unilateral and 1 (3.33%) patient treated with bilateral adductor tenotomy, closed reduction and hip spica application.  Nine (30%) patients treated with unilateral and 3 (10%) patients treated with bilateral adductor tenotomy, open reduction and hip spica app-lication. Four (13.33%) patients treated with bilateral adductor tenotomy, open reduction and hip spica app-lication. Four (13.33%) patients treated with unilateral and 4 (13.33%) patients treated with bilateral complex surgical procedure of adductor tenotomy, illiopsoas release, open reduction, femoral derotation osteotomy, femoral shortening and capsulorraphy of the hip joint.

Conclusion:  In this demographical study of idiopathic developmental dysplasia of hip, it was observed that the age of presentation and positive family history were alarmingly high as compared to other reference studies. Therefore, it is concluded that public aware-ness campaigns, national screening programs and gen-etic counseling should be introduced for better man-agement of idiopathic developmental dysplasia of hip.

Keywords:  Idiopathic Developmental dysplasia of
Hip - Demography.