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Topic:

Developmental Dysplasia of the Hip

Issue:

Hip

Category:

Developmental

Title:

Follow-up Value of Hip Medial Ultrasound in Infants and Children With Developmental Dysplasia of the Hip Treated With Reduction and Spica Casting

Author:

Yu, Jingmiao MM; Chen, Tao MD; Fu, Gang MD; Lyu, Xuemin MD; Wang, Chao MD, PhD; Wang, Yukun MM; Yang, Zheng MD; Guo, Wen MM

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4):p 236-243, DOI: 10.1097/BPO.0000000000002626

Level Of Evidence:

II

# of Patients:

49

Study Type:

Retrospective analysis

Location:

Not specified

Summary:

This study evaluates the role of hip medial ultrasound in monitoring the progression of femoral head docking in children with DDH treated with closed or open reduction followed by spica casting. Measurements of triradiate cartilage-femoral head distance (TFD) were compared over time to assess the reduction and positioning of the femoral head within the acetabulum.

Methods:

Patients underwent closed or open reduction for DDH, followed by spica casting. Medial ultrasound imaging was performed immediately post-reduction and at intervals during the immobilization period. TFD values were measured at three key points: immediately after stage I casting, 4–8 weeks later (stage I follow-up), and after stage II casting (if applicable). Wilcoxon signed-rank test compared TFD values over time.

Exclusions:

Not specified

Results:

Significant reduction in TFD values was observed between immediate post-reduction (6.0 mm) and follow-up after stage I casting (5.0 mm) (P < 0.001). Similar results were found for open reduction cases (6.0 mm vs. 5.0 mm, P = 0.023). The ultrasound effectively quantified changes in femoral head position within the acetabulum.

Conclusions:

Hip medial ultrasound is a valuable tool for objectively assessing hip reduction and tracking the dynamic progression of femoral head docking in DDH patients undergoing spica casting. This imaging modality can provide real-time data to guide clinical decision-making during cast immobilization.

Relevance:

Limitations:

Perspective:

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