â– LECTURE OVERVIEW: Developmental Dysplasia of the Hip (DDH) encompasses a spectrum of congenital hip abnormalities characterized by abnormal acetabular development and hip instability in newborns.
â– ANATOMICAL SUBSTRATES:
1. Acetabular Dysplasia: The acetabulum is abnormally shallow, preventing the femoral head from seating securely inside the hip socket.
2. Laxity Strain: Excess ligamentous laxity allows the femoral head to slip backward out of the socket.
3. Pathological Remodeling: Scleral and cartilage transformations occur, creating a flattened socket that can lead to permanent limb shortening and an asymmetrical gait if untreated.
â– SURGICAL LANDMARKS & ANATOMICAL BOUNDARIES:
Intraoperative access requires meticulous dissection along defined tissue planes. Avoid excessive traction near neurovascular bundles and look for key bony landmarks or fascial reflections to secure margins.
â– COMPENSATORY HORMONAL & VASCULAR FEEDBACK:
Acute systemic shifts trigger immediate neural and hormonal reflexes to preserve blood flow to vital organs like the brain and kidneys.
[HY-BOARD-1393]
🌟 Dynamic Clinical Key:
Infants are screened using Barlow (adducts and exerts posterior pressure to dislocate an unstable hip out of the acetabulum) and Ortolani (abducts and exerts anterior traction to reduce a dislocated hip back into the acetabulum) maneuvers. Early diagnosis is managed with a Pavlik harness to hold the hip in flexion and abduction. Never divide or ligate any vessel before clearly isolating and confirming its origin and termination. Carefully evaluate the underlying cause of high blood pressure before aggressively suppressing compensatory vasoconstriction.