Rapatalo, Paul Vincent P.

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Congenital Hip Dysplasia

• Rapatalo, Paul Vincent P.

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CONGENITAL HIP DYSPLASIA

• DEFINITION IT IS THE IMPROPER FORMATION AND
  FUNCTION OF THE HIP SOCKET.
• ALSO KNOWN AS
• DEVELOPMENTAL HIP DYSPLASIA

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SIGNS AND SYMPTOMS

• ONE LEG IS SHORTER

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SIGNS AND SYMPTOMS

• UNEQUAL SKIN FOLDS

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SIGNS AND SYMPTOMS
ORTOLANI MANEUVER 1. Lay infant supine and flex
90 2. Place your middle fingers over the
greater trochanter of the femur and your thumb
on the internal side of the thigh over the lesser
trochanter 3. Abduct the hips while applying
upward pressure over the greater Trochanter,
and listen for a clicking sound.
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SIGNS AND SYMPTOMS

• ORTOLANI MANEUVER
• PRINCIPLE
• Normally, no sound is heard. A
• Clicking or clunking sound is positive
• Ortolanis sign and occurs when the
• femoral head re-enters the
• acetabulum.

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SIGNS AND SYMPTOMS

• BARLOWS MANEUVER
• 4. Next, with your fingers in the
• same position, and holding the hips
• and knees at 90 flexion, apply a
• backward pressure (down and
• laterally) and adduct the hips.
• Note any feeling of femoral head
• slipping.

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SIGNS AND SYMPTOMS

• BARLOWS MANEUVER
• PRINCIPLE
• Normally, the hip joint is stable.
• A feeling of the femur head
• slipping out of the socket
• posterolaterally is a positive
• Barlows sign indicative of
• hip instability associated with
• Developmental Hip Dysplasia.

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PATHOPHYSIOLOGY

• ABNORMAL GROWTH OF HIP
• LIGAMENTOUS LAXITY

NORMAL
ABNORMAL
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DIAGNOSTIC EXAMS

• PELVIC X-RAY FOR OVER 4 MONTHS
• ULTRASOUND FOR 1-4MONTHS OLD
• MRI

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TREATMENT AND MANAGEMENT

• FREJKA SPLINT WORN AT ALL TIMES
• EXCEPT WHEN CHANGING DIAPERS OR BATHING THE
  INFANT.

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TREATMENT AND MANAGEMENT

• PAVLIK HARNESS
• METHOD OF CHOICE
• FOR LONG TERM
• THERAPY( BECAUSE
• IT TAKES 3-4 WKS
• THERAPY AND
• INVOLVES
• SIMPLIFIED CARE)

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TREATMENT AND MANAGEMENT

• SPICA CAST OR
• FROG-LEG CAST
• FOR FULLY DISLOCATED
• OR SEVERE SUBLUXATION.
• HEAVY AND WIDE.
• NEWBORNS CANNOT SAY
• THAT THE CAST IS
• CAUSING CIRCULATORY
• CONSTRICTION

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TREATMENT AND MANAGEMENT

• TRACTION FOR OLDER CHILDREN
• SURGERY AND INSERTION OF PIN
• TOTAL HIP ARTHROPLASTY ONCE A CHILD HAS ACHIEVED
  SKELETAL MATURITY (APPROXIMATELY 16YRS OLD IN
  FEMALES, 18YRS OLD IN MALES)

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NURSING CARE

• IMPAIRED PHYSICAL MOBILITY
• Related to Musculoskeletal impairment (hip
  defect).
• Defining Characteristics imposed restriction
  of movement by harness, cast, traction, or
  splint inability to purposefully move within
  physical environment including bed mobility
  ambulation.

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NURSING CARE

• RISK FOR IMPAIRED SKIN INTEGRITY
• Related to External factor of physical
  immobilization internal factor of altered
  circulation sensation by pressure of device.
• Defining Characteristics Edema, tight appliance
  or cast, change in skin color and temperature
  proximal to spica cast, skin irritation at cast
  edges, numbness proximal to cast.

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NURSING CARE

• CONSTIPATION
• Related to Musculoskeletal impairment,
  inadequate physical activity or immobility.
• Defining Characteristics Frequency less than
  usual, hard formed stool, decreased bowel sounds,
  straining at defecation.

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NURSING CARE

• DELAYED GROWTH AND DEVELOPMENT
• Related to Effects of physical disability
  (immobilization).
• Defining Characteristics Environmental and
  stimulation deficiencies, inability to perform
  self-care activities appropriate for age,
  isolation with long-term immobilization.

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NURSING CARE

• RISK FOR INJURY
• Related to untreated or improper treatment for
  dislocation.
• Defining Characteristics late onset dislocation,
  absence of early recognition and intervention for
  correction, muscle contracture, muscle
  shortening, femoral and acetabulum deformity,
  tight spica cast, inappropriate traction or
  malfunctioning traction.

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NURSING CARE
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NURSING CARE
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NURSING CARE
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REFERENCES

• Delmar's Pediatric Nursing Care Plans - 3rd Ed.
  (2005)
• Maternal and Child Health Nursing 5thEd.
  Pillitteri (2007)
• Answers.com
• eMedicine.com
• StatRef.com
• eMedicine.com

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REFERENCES

• Chiroweb.com
• Wikipedia.com
• Google.com
• Yahoo.com
• Uberme.com