NEW HORIZONS Endoscopic Scoliosis Surgery

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AP PELVIS Only a simple film but an important
one!
Anne Connell Mater Childrens Hospital
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• The hip is a ball and socket joint. The ball is
  the femoral head and the socket is the
  acetabulum.
• At birth, the femoral head and the acetabulum are
  made of mostly cartilage and are relatively soft.
  For the joint to form properly, the femoral head
  and acetabulum must be orientated correctly.
• DDH is a progressive condition in which this
  does not happen. The term encompasses many
  abnormalities, from mild under-development of new
  born hips to the stiff unreducible hip.
• Imaging U/S up to 4-6mths until femoral heads
  ossify

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The Hilgenreiner Line is a horizontal line drawn
through the top of the triradiate cartilage.
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NAPPIES !!!!
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18 Months old parents noticed asymetrical walk
NO PAIN Active child who had an odd crawl
Dislocated hip Delayed femoral head ossification
centre Significant acetabular dysplasia
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TRAUMA TRAMPOLINE INJURY
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SUFE or SCFE Usually 11 to 15 year old (mostly
males) Pain in hip Limp Often also pain in
knee May have no history of trauma
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FIVE THINGS TO REMEMBER
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MANY THANKS TO
Kerry Carapeto for sharing her pelvis DDH
research Ivan Simic for computer
assistance Gerard Duckworth for photo
assistance Kelly Paterson for CP
information Lisa and her lovely daughter
Addison for photographs Fiona for modelling her
feet photos
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References
Concensus Statement for Hip Surveillance for
children with CP Standards of care 2008
Wheeless Textbook of Orthopaedics
F Gaillard Images from from Radiopedia
www.pediatric-orthopedics/DDH