Bhaskar Atul, Doshi Chintan, Nagda Taral, Bhaskar Daksh
Children Orthopaedic Surgical Services, Apt 3/Bldg No 18, Mhada Complex, Oshiwara Link Road, Mumbai, 400053 India.
Indian J Orthop. 2021 Oct 28;55(6):1596. doi: 10.1007/s43465-021-00528-w. eCollection 2021 Dec.
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.
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.
This article highlights the signs of DDH that every clinician dealing with children must be well-versed.
The online version contains supplementary material available at 10.1007/s43465-021-00528-w.
发育性髋关节发育不良(DDH)的早期诊断仍然难以捉摸。在没有症状的情况下,早期体征需要提高警惕并进行敏锐的临床检查。
每个新生儿都必须通过巴洛试验和奥托拉尼试验检查髋关节的稳定性。定期检查下肢是否存在肢体长度差异、髋关节外展受限、大腿或臀纹不对称,这必须提醒检查者排除髋关节发育不良。在患有单侧DDH的学步儿童中,跛行明显,单足站立试验阳性。在双侧DDH中,髋关节外展受限和伴有腰椎前凸增加的摇摆步态是唯一早期可察觉的体征。护理人员或父母常常会注意到肢体不对称的细微变化,并告知初级保健医生。为防止DDH晚期出现,这些早期体征绝不能被忽视。
本文强调了每位诊治儿童的临床医生都必须熟知的DDH体征。
网络版包含可在10.1007/s43465-021-00528-w获取的补充材料。