Total hip replacement for developmental dysplasia of hip and postoperative nursing.

This study was designed to determine the clinical effect of total hip replacement for the treatment of developmental dysplasia of the hip (DDH) and analyze the postoperative nursing. Sixty patients (78 hips) aged 18-75 years (average 58.6±2.31 years) who received total hip replacement for treatment of DDH at the Zhengzhou People’s Hospital, Henan, China, from April 2013 to June 2016 were selected as research subjects. Twenty-four patients were male (30 hips) and 36 were female (48 hips). Of the 60 patients, according to Crowe typing, 24 were type I (30 hips), 26 were type II (34 hips), 6 were type III (8 hips) and 4 were type IV (6 hips). According to the Harris hip score system, the score of all hips was 39.46±3.56 points average (18-56 points) before treatment and resulted as 89.60±4.25 points (79-98 points) at the last follow-up, showing a statistically significant difference (P < 0.05). Complications such as wound infection, dislocation, fracture of femoral shaft, femoral nerve and injury of sciatic nerve were not found after treatment. A total of 48 cases (58 hips) obtained excellent curative results (93.33% recovery), 8 cases (14 hips) good (92.31% recovery), and 4 cases (6 hips) medium. Total hip replacement proved to be effective in treating DDH and secondary osteoarthritis. Moreover, soft tissue release and an optimum degree recovery of anatomic form and physiological function of the diseased hip is an important basis for reconstructing the acetabulum and stabilizing acetabulum prosthesis.

Examination of the newborn: the key skills. Part 3: the hips.

Midwives are increasingly performing the examination of the newborn. his article considers the importance of the examination of the hips in the screening process. The significance of history taking, knowledge of risk factors and the hip examination will be explored. The necessity for early detection and treatment of hip abnormalities, along with referral pathways that the National Screening Committee quires will be highlighted. The impact of late detection of developmental dysplasia of the hip (DDH) on the lives of families and children will also be considered.

Developmental dysplasia of the hip.

The close interaction between community practitioners and young families provides an invaluable opportunity for prevention, education, support and even diagnosis in cases of developmental hip dysplasia. This article provides a brief overview of the condition, including clinical findings, screening protocols, 'hip safe' practices, and common treatments that may be encountered in the community.

The knowledge, attitude and practice of the primary and secondary care nurse-midwife practitioners on developmental dysplasia of hip.

A detailed clinical examination of the newborn performed by nurse-midwife practitioners has been recommended as a standard practice throughout the most western countries. The purpose of this study was to evaluate and compare the knowledge, attitude and practice of the primary and secondary care nurse-midwife practitioners on developmental dysplasia of hip (DDH) before and after a structured lesson. The study was designed as a cross-sectional, pre- and post-test. The number of participants from primary care and secondary care nurse-midwife practitioners were 155 and 208, respectively. A structured questionnaire consisting of 28 statements of medical and practical knowledge, and traditional attitudes with regard to DDH was administered. The results determined that the pre-test scores were much lower than the post-test scores of both primary and secondary care practitioners. Although there was a lack of knowledge about DDH in both groups, the pre-test and post-test scores were higher in the primary care group compared to the secondary care group. In conclusion, the knowledge, attitude and practice of the primary and secondary care nurse-midwife practitioners on developmental dysplasia of hip are in need of improvement. This improvement may be provided by continuing education programmes.

Exploring the experiences of parents caring for infants with developmental dysplasia of the hip attending a dedicated clinic.

Specialised DDH (developmental dysplasion of the hip) clinics are developing around Ireland but are, however, variable in how they are operated. A DDH clinic was set up in the South-east of Ireland in 2002 with the goal of achieving an integrated care pathway between the orthopaedic surgical team and nursing team, working to an explicit protocol while also fostering a strong collaboration with the ultrasound department. This paper aims to explore the effectiveness of this dedicated clinic in the Southeast of Ireland.

[Knowledge and attitude of nursing and midwifery college students on developmental dysplasia of the hip]. / Hemsirelik ve ebelik bölümü ögrencilerinde gelisimsel kalça displazisi konusundaki bilgi ve tutumun degerlendirilmesi.

OBJECTIVES: It is of special importance to educate families and health care providers, in particular midwives and nurses who are in close and frequent contact with families, for the prevention and early diagnosis of developmental dysplasia of the hip (DDH). A knowledge and attitude study was conducted concerning DDH among students of Nursing and Midwifery College of Kahramanmaras Sütçü Imam University. METHODS: A structured form was prepared consisting of 28 statements about medical and practical knowledge and traditional attitudes with regard to DDH and was administered to 232 voluntary students before and after an educational session of 60 minutes by a specialist in orthopedics. Prior to the study, the students of grade I and II had not received any theoretical or practical lectures about DDH, which were included in the curriculum of grades III and IV. RESULTS: The knowledge of the students about risk factors and prevention strategies for DDH was of a moderate level. They were not sufficiently furnished with information about traditional attitudes and applications that predispose infants to DDH. The mean test scores before and after training were 51.52+/-13.90 and 87.86+/-5.90, respectively (p=0.000). Compared to grade III and IV students, grade I students performed significantly less in the former test (p=0.00); however, the scores of the latter test did not differ significantly between the grades (p>0.05). CONCLUSION: The curriculum during the license education of midwives and nurses should include essential information on traditional attitudes. With sufficient knowledge and application skills, midwives and nurses may play an important role in the primary and secondary prevention of DDH in our country.

Traction at home for infants with developmental dysplasia of the hip.

Early treatment of developmental dysplasia of the hip in infants is essential for optimal development of the hip joint. Orthopaedists commonly use a period of preliminary traction before hip reduction to stretch the soft tissues and reduce the risk of avascular necrosis. A program developed at the University of Michigan Medical Center allows the infant to receive traction at home instead of the traditional admission to the hospital. This program has been found to be clinically effective as well as cost effective, and less of an inconvenience to the infant and family than the traditional admission. Intensive involvement by the clinical nurse specialist in teaching and follow-up of each patient is essential for success.

Developmental dysplasia of the hip.

Developmental dysplasia of the hip (DDH), formerly known as congenital dislocation of the hip (CDH), is a term used to describe a variety of abnormalities of the hip in development. The treatment options are diverse depending on etiology, degree of dislocation, and age of the child when diagnosis is made. This article provides the reader with a knowledge base to assist with early diagnosis, treatment, and nursing care of the client with dislocations and subluxations of the hip. Presented are the definitions, diagnostic techniques, treatments, and nursing diagnoses and interventions for the client with DDH and for the child's family.

Caring for a young child in a body cast: impact on the care giver.

Data from an open-ended questionnaire and the comments section of a structured questionnaire were combined and analyzed to determine the challenges faced and alterations in usual daily activities required by mothers caring for a young child at home in a body cast. The sample consisted of 35 mothers who identified themselves as the primary care givers of a child in a body cast. The challenges of caring for a child in a body cast required major adjustments in almost every aspect of the mothers' lives, including household activities, social and community activities, child care activities, personal care activities, occupational activities, and educational activities.

Care of the infant in a Pavlik harness.

Congenital hip dysplasias, a common orthopaedic problem in children, can be treated effectively if diagnosed early. One such valuable tool in treating this disorder is the Pavlik Harness. These authors describe their child's experience with the Pavlik Harness along with the personal needs of the child and family.

Bernese periacetabular osteotomy for hip dysplasia in young adults.

Hip dysplasia is one of the most common disorders of the hip, presenting in the first three years of life. Literature has shown that an association exists between developmental dysplasia of the hip and the development of secondary hip osteoarthritis in early adulthood. Treatment options are directed toward relieving symptoms and delaying or preventing the onset of arthritis in the affected hip. Total hip arthroplasty is a surgical option, but has been associated with a high rate of failure in younger, physically active patients. This article discusses the Bernese periacetabular osteotomy procedure as a treatment modality, which restores coverage of the femoral head with the acetabulum. Changing the anatomy allows the surgeon to increase the surface area of the femoral head that bears the patient's weight. Increasing the weight-bearing surface may prevent further damage to the hip's cartilage and delay the onset of osteoarthritis.

Practical primary pediatric orthopedics.

Pediatric orthopedic problems often puzzle the primary health provider and worry families. A thorough orthopedic history and examination by the primary care provider is all that is necessary to determine whether a problem requires further evaluation and referral. This article addresses a practical approach to common orthopedic problems, assessment, and management strategies from the specialist perspective. A general description of developmental dysplasia of the hip, foot misalignments, tibial torsion, toe-walking, genu varum (bowlegs), growing pains, sprains and fractures, and the child with a limp is provided. Management strategies before and after orthopedic referral are presented.

Congenital hip dislocation: the importance of early detection and comprehensive treatment.

Hip dislocation is the musculoskeletal condition most commonly missed during neonatal examinations. Failure to diagnose the condition can lead to long-term disability and is a common target in pediatric legal suits concerning damage to the musculoskeletal system. Early neonatal assessment for hip dislocation includes an examination using the Barlow and Ortolani tests. Later examinations include assessment of gluteal folds, knee height and the degree of hip abduction. The preferred treatment is use of the Pavlik harness, an outpatient treatment regime that provides effective reduction in 90 percent of the cases. The harness uses flexion and free abduction to direct the femoral head into the acetabulum; it uses time, gravity and motion to position the hip in a reduced position. The harness requires three to six months of continuous wear for the hip to become radiographically stable. Health care providers are instrumental in diagnosing congenital hip dislocation and teaching families how to promote the infant's physical and psychosocial well-being. If this condition is not detected until after the infant is 6 weeks old, or the harness is ineffective after three weeks, skin traction, closed reduction and spica-cast application may be needed. Open reduction and recasting are also options. In rare cases, total hip replacement is necessary in later life.