Cargando…
Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report
INTRODUCTION: Developmental dysplasia of hip (DDH) is abnormal development of hip joint causing mild subluxation to complete dislocation of femoral head from acetabulum. Incidence in India is 1–9.2/1000 . Typical risk factors for DDH are said to be female child, first born, breech position, positive...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Indian Orthopaedic Research Group
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826564/ https://www.ncbi.nlm.nih.gov/pubmed/36660148 http://dx.doi.org/10.13107/jocr.2022.v12.i05.2828 |
_version_ | 1784866882392686592 |
---|---|
author | Mahajan, Neetin P Kondewar, Pranay Ghoti, Santosh Wadia, Farokh Chaudhari, Kunal |
author_facet | Mahajan, Neetin P Kondewar, Pranay Ghoti, Santosh Wadia, Farokh Chaudhari, Kunal |
author_sort | Mahajan, Neetin P |
collection | PubMed |
description | INTRODUCTION: Developmental dysplasia of hip (DDH) is abnormal development of hip joint causing mild subluxation to complete dislocation of femoral head from acetabulum. Incidence in India is 1–9.2/1000 . Typical risk factors for DDH are said to be female child, first born, breech position, positive family history, left hip, and unilateral involvement. Femoral head and acetabular compressive forces are mutually important stimulators for normal growth (both shape and depth). Deviation from above normal process due to subluxated or dislocated head since birth can lead to abnormal development of both acetabulum and femoral head. Diagnosis of the DDH is made at birth using clinical test and radiologically using ultrasound of hip joint. Management is based on the age of presentation and severity of the instability. Most hips are managed conservatively management depends on the age and symptoms of the patient. CASE REPORT: A 14-year-old female child presented with the complaints of pain in the left hip and difficulty in walking. On clinical and radiological examination, she was diagnosed to have developmental dysplasia of the left hip with partial subluxation of the left hip. Thorough investigation and planning were done using CT PBH and 3D reconstruction of the pelvis to plan the osteotomy. Stages surgery was planned, first, triple innominate osteotomy was performed and later femoral varus derotation osteotomy 6 weeks later. At 3-year follow-up, the patient is pain free and is having no difficulty in doing day-to-day activities. X-ray showing complete coverage of the femoral head with no changes of arthritis in hip. CONCLUSION: Late presentations of neglected developmental dysplasia poses difficult challenges in management. It can be addressed with osteotomies for improving range of motion and preventing future early arthritis. In our case, good functional range of motion was restored at 3 years follow-up. |
format | Online Article Text |
id | pubmed-9826564 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Indian Orthopaedic Research Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-98265642023-01-18 Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report Mahajan, Neetin P Kondewar, Pranay Ghoti, Santosh Wadia, Farokh Chaudhari, Kunal J Orthop Case Rep Case Report INTRODUCTION: Developmental dysplasia of hip (DDH) is abnormal development of hip joint causing mild subluxation to complete dislocation of femoral head from acetabulum. Incidence in India is 1–9.2/1000 . Typical risk factors for DDH are said to be female child, first born, breech position, positive family history, left hip, and unilateral involvement. Femoral head and acetabular compressive forces are mutually important stimulators for normal growth (both shape and depth). Deviation from above normal process due to subluxated or dislocated head since birth can lead to abnormal development of both acetabulum and femoral head. Diagnosis of the DDH is made at birth using clinical test and radiologically using ultrasound of hip joint. Management is based on the age of presentation and severity of the instability. Most hips are managed conservatively management depends on the age and symptoms of the patient. CASE REPORT: A 14-year-old female child presented with the complaints of pain in the left hip and difficulty in walking. On clinical and radiological examination, she was diagnosed to have developmental dysplasia of the left hip with partial subluxation of the left hip. Thorough investigation and planning were done using CT PBH and 3D reconstruction of the pelvis to plan the osteotomy. Stages surgery was planned, first, triple innominate osteotomy was performed and later femoral varus derotation osteotomy 6 weeks later. At 3-year follow-up, the patient is pain free and is having no difficulty in doing day-to-day activities. X-ray showing complete coverage of the femoral head with no changes of arthritis in hip. CONCLUSION: Late presentations of neglected developmental dysplasia poses difficult challenges in management. It can be addressed with osteotomies for improving range of motion and preventing future early arthritis. In our case, good functional range of motion was restored at 3 years follow-up. Indian Orthopaedic Research Group 2022 2022-05 /pmc/articles/PMC9826564/ /pubmed/36660148 http://dx.doi.org/10.13107/jocr.2022.v12.i05.2828 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Mahajan, Neetin P Kondewar, Pranay Ghoti, Santosh Wadia, Farokh Chaudhari, Kunal Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report |
title | Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report |
title_full | Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report |
title_fullStr | Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report |
title_full_unstemmed | Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report |
title_short | Management of Neglected Developmental Dysplasia of the Left Hip in a 14-Year-Old Child with Staged Osteotomies Planned with 3D-Printed Model – A Case Report |
title_sort | management of neglected developmental dysplasia of the left hip in a 14-year-old child with staged osteotomies planned with 3d-printed model – a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826564/ https://www.ncbi.nlm.nih.gov/pubmed/36660148 http://dx.doi.org/10.13107/jocr.2022.v12.i05.2828 |
work_keys_str_mv | AT mahajanneetinp managementofneglecteddevelopmentaldysplasiaofthelefthipina14yearoldchildwithstagedosteotomiesplannedwith3dprintedmodelacasereport AT kondewarpranay managementofneglecteddevelopmentaldysplasiaofthelefthipina14yearoldchildwithstagedosteotomiesplannedwith3dprintedmodelacasereport AT ghotisantosh managementofneglecteddevelopmentaldysplasiaofthelefthipina14yearoldchildwithstagedosteotomiesplannedwith3dprintedmodelacasereport AT wadiafarokh managementofneglecteddevelopmentaldysplasiaofthelefthipina14yearoldchildwithstagedosteotomiesplannedwith3dprintedmodelacasereport AT chaudharikunal managementofneglecteddevelopmentaldysplasiaofthelefthipina14yearoldchildwithstagedosteotomiesplannedwith3dprintedmodelacasereport |