![]() ![]() If DDH is suspected, an examination of the hip should be undertaken. ![]() The incidence of DDH may be influenced by local child-rearing practices, as certain swaddling and baby-carrying techniques have been shown to correlate with a decline in this disorder. The exact cause of DDH is unknown but risk factors for DDH include: Due to the nature of how the baby sits in the womb, the left hip is more commonly affected. 4,5ĭDH is the most common abnormality in newborn infants. 3ĭDH is a disorder of abnormal development resulting in dysplasia and potential subluxation or dislocation of the hip secondary to capsular laxity and mechanical factors. Radiographic bony features of the pelvis and hip. It is important to differentiate SCFE from Salter-Harris fracture as treatment is different.Figure 2. Prophylactic pinning of contralateral hip is advocated by some authors but others prefer to closely monitor it for 1-2 years instead. In moderate to severe SCFE, intertrochanteric or subtrochanteric osteotomies are advised due to excellent results and low occurrence of osteoarthritis and AVN. Additional femoral head-neck osteochondroplasty performed in mild SCFE is thought to prevent femoroacetabular impingement too, but further study is needed to determine whether it is justified to prevent articular damage. Prevention of early osteoarthritis, avascular necrosis and additional displacement along with achieving optimal functional outcome are the primary goal of treatment which can be achieved by stabilization of the epiphysis with in-situ pin or screw placement. Late complications are 'pistol grip' deformity or CAM-type femoroacetabular impingement leading to articular chondral damage, osteoarthritis, limb length discrepancy AVN (avascular necrosis) is associated with advanced unstable slippage, extensive manipulation, delayed surgery, anterior or many pin placement, subcapital and neck osteotomies. ![]() USG and MR can also aid in reaching the diagnosis.Įarly complication are slip progression, hardware loosening, chondrolysis. Line of Klein and metaphyseal blanch sign can help make the diagnosis. Radiologically mild to severe displacement depends on the degree of femoral head displacement compared to the diameter of metaphysis. Acute slip is seen as a fracture without sclerosis at the physis, in contrast to acute-on-chronic slip, which shows sclerosis and irregularity around the widened physis with associated remodelling in the femoral neck. Other factors such as genetics, biomechanical forces, metabolic disorders are postulated to cause slippage by pathological distubances in physis įrequently presenting symptoms are painful hip or knee or limp which can be misdiagnosed as muscle strain, Osgood-Schlatter disease or flat feet and delay in diagnosis often leads to poor long-term results due to progression in slip severity Īnterior, lateral and frog leg lateral radiographs with gonad protection are performed, which shows widening of the physis with or without demineralization in pre-slip phase. Slipped capital femoral epiphysis (SCFE), a nontraumatic fracture through growth plate with anterior displacement of the femoral neck metaphysis relative to the epiphysis, is the most common hip abnormality in adolescents with frequent lifelong sequelae, having a prevalence of 2 cases per 100, 000 children which predominantly affects boys in the age group of 8-15 years, suggesting association with growth spurt and changing orientation of physis from horizontal to oblique. ![]()
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