Verification of hip reduction using anterior ultrasound scanning during Pavlik harness treatment of developmental dysplasia of the hip

2.50
Hdl Handle:
http://hdl.handle.net/11287/593838
Title:
Verification of hip reduction using anterior ultrasound scanning during Pavlik harness treatment of developmental dysplasia of the hip
Authors:
Carlile, G. S.; Woodacre, Timothy; Cox, Peter J.
Abstract:
AIM: Ultrasound scanning (USS) is used for diagnosis and surveillance in developmental dysplasia of the hip (DDH). Lateral coronal scanning is performed with the hip flexed, in neutral adduction. In this position an unstable hip may dislocate, failing to demonstrate a reducible hip, leading to abandonment of harness treatment. Anterior ultrasound permits imaging of the flexed abducted hip in harness. This study evaluates the role of anterior & lateral USS in determining duration of treatment and reduction in DDH. METHOD: Between 1997 & 2010, 233 patients requiring harness treatment received lateral USS, with dislocated & dysplastic hips re-imaged fortnightly. From 2005, anterior USS was used additionally to assess reduction in harness. RESULTS: One-hundred and eighteen patients (167 hips) received lateral USS, 115 (160 hips) received both. In the lateral cohort, 103 (140 hips) were treated successfully, mean duration 66.2 days (95% CI 60.2-72.1), with 15 (26 hips) failures (15.5%), mean 30 (CI 95% 19.3-40.6). In the anterior cohort, 107 (150 hips) were treated successfully, mean 53.3 (95% CI 49.8-56.7), with 8 (10 hips) failures (6.25%), mean 35.3 (CI 95% 25.5-44.9). Children receiving an anterior USS had a shorter duration of treatment (p = 0.011) and no difference in failures (p = 0.21). CONCLUSIONS: A reduced duration of treatment for Graf 3 hips was observed. Anterior ultrasound allows earlier recognition of hips that fail to stabilize, via two observed modes of failure; failure of hip reduction and failure to stabilize after reduction.
Citation:
J Orthop. 2014 Dec;11(4):174-9
Publisher:
Elsevier
Journal:
Journal of orthopaedics
Issue Date:
1-Dec-2014
URI:
http://hdl.handle.net/11287/593838
DOI:
10.1016/j.jor.2014.08.001
PubMed ID:
25561752
Additional Links:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281631/
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article
Language:
eng
ISSN:
0972-978X
Appears in Collections:
General Trauma & Orthopaedics; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorCarlile, G. S.en
dc.contributor.authorWoodacre, Timothyen
dc.contributor.authorCox, Peter J.en
dc.date.accessioned2016-01-19T12:35:36Zen
dc.date.available2016-01-19T12:35:36Zen
dc.date.issued2014-12-01en
dc.identifier.citationJ Orthop. 2014 Dec;11(4):174-9en
dc.identifier.issn0972-978Xen
dc.identifier.pmid25561752en
dc.identifier.doi10.1016/j.jor.2014.08.001en
dc.identifier.urihttp://hdl.handle.net/11287/593838en
dc.description.abstractAIM: Ultrasound scanning (USS) is used for diagnosis and surveillance in developmental dysplasia of the hip (DDH). Lateral coronal scanning is performed with the hip flexed, in neutral adduction. In this position an unstable hip may dislocate, failing to demonstrate a reducible hip, leading to abandonment of harness treatment. Anterior ultrasound permits imaging of the flexed abducted hip in harness. This study evaluates the role of anterior & lateral USS in determining duration of treatment and reduction in DDH. METHOD: Between 1997 & 2010, 233 patients requiring harness treatment received lateral USS, with dislocated & dysplastic hips re-imaged fortnightly. From 2005, anterior USS was used additionally to assess reduction in harness. RESULTS: One-hundred and eighteen patients (167 hips) received lateral USS, 115 (160 hips) received both. In the lateral cohort, 103 (140 hips) were treated successfully, mean duration 66.2 days (95% CI 60.2-72.1), with 15 (26 hips) failures (15.5%), mean 30 (CI 95% 19.3-40.6). In the anterior cohort, 107 (150 hips) were treated successfully, mean 53.3 (95% CI 49.8-56.7), with 8 (10 hips) failures (6.25%), mean 35.3 (CI 95% 25.5-44.9). Children receiving an anterior USS had a shorter duration of treatment (p = 0.011) and no difference in failures (p = 0.21). CONCLUSIONS: A reduced duration of treatment for Graf 3 hips was observed. Anterior ultrasound allows earlier recognition of hips that fail to stabilize, via two observed modes of failure; failure of hip reduction and failure to stabilize after reduction.en
dc.language.isoengen
dc.publisherElsevieren
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281631/en
dc.titleVerification of hip reduction using anterior ultrasound scanning during Pavlik harness treatment of developmental dysplasia of the hipen
dc.typeJournal Articleen
dc.identifier.journalJournal of orthopaedicsen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en
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