![]() ![]() 20 The International Hip Dysplasia Institute maintains a list of ‘hip-healthy’ early childcare products. 20 Optimal babywearing has been proposed as a public health initiative to minimise DDH. 22,23 Conversely, habitually carrying babies with hips flexed and abducted is associated with low DDH incidence. 19–21 High rates of swaddling are seen in patients with DDH diagnosed after three months of age. ![]() Tight swaddling of lower limbs in extension and adduction is associated with DDH in epidemiological, anatomical and animal studies. Hip development can be affected postnatally. 17 There is ongoing debate as to whether foot abnormalities and oligohydramnios are truly risk factors. 17 The estimated risk for males with a family history (9.4/1000) is lower than females in general (19/1000). The highest DDH risk is in female breech babies (absolute risk 120/1000), followed by females with a family history (44/1000), then male breech babies (26/1000). 17 Associated gene defects occur in the transforming growth factor beta superfamily, necessary for normal bone and joint development. Risk factors and prevention of DDHĭDH results from a combination of environmental and genetic factors. This paper presents an evidence-based approach to DDH prevention and early detection using assessment and surveillance, suitable for general practitioners (GPs). 4Ĭurrent DDH screening practices are criticised for failure to adhere to the general principles of health screening, 8,9 and there is variability in Australian neonatal hip screening guidelines. 4 For children born in 2003–2009, 11.5% of cases were a late diagnosis after three months of age. 6,7 In South Australia, where DDH is notifiable to the South Australian Birth Defects Register, the incidence is around seven per 1000 live births. There is no standard definition and no consensus regarding which clinical examination and imaging findings require treatment to permit normal hip development. 2–4ĬDH was renamed developmental dysplasia of the hip (DDH) 5 and describes a range of paediatric hip conditions including instability, acetabular dysplasia, subluxation and dislocation. However, late detection of hip dislocations, including at walking age, have increased in Australia since 2003. 1 In Australia, a newborn congenital dislocation of the hip (CDH) screening program was implemented in the 1960s. Hippocrates promoted early treatment of infantile hip dislocations almost 2400 years ago. Articles in this series aim to provide information about diagnosis and management of presentations in infants, toddlers and pre-schoolers in general practice. This article is the third in a series on paediatric health. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |