The Hip: Preservation, Replacement and Revision

Physical Exam of DDH



- See: Impediments to Reduction

- Early DDH:
     - Barlow's Test
     - Ortolani's test
     - Hip Clicks:
           - common occurance on physical exam;
           - there is no published significance of hip clicks;

- Late DDH:
    - tightness of adductors; (limited abduction);
           - this becomes the most consistent sign of DDH after 2-3 months of age;
           - in the report by Omeroglu and Koparal, limitation of abduction and asymmetry of the skin folds were the two most common clinical findings associated with DDH.
                  - The role of clinical examination and risk factors in the diagnosis of developmental dysplasia of the hip: a prospective study in 188 referred young infants.
    - extra skin folds;
    - since femoral head is not contained w/ in acetabulum, thigh is shortened, skin and subcutaneous tissue bunch up;
    - allis or galeazzi's sign:
          - w/ patient supine & hips and knees flexed, knees are not at same level;
    - pistoning, or telescoping
          - femur can be freely moved up and down;
    - trendelenburg gait:
          - child walks w/ a significant limp because of shortening of the limb, telescoping of femoral head on the pelvis, and a contralateral tilt of pelvis due to abductor muscle weakness


Early Diagnosis and Treatment of Congenital Dislocation of the Hip.

Joint laxity and hip rotation in normal children and in those with congenital dislocation of the hip.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, August 9, 2012 10:37 am