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– HISTOCHEMICAL & SPECIAL STAIN ANALYSIS:
Tissue examination is enhanced by specialized dyes and immunophenotypic markers that target cellular structure with remarkable specificity.
[HY-BOARD-1333]
🌟 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. Always cross-reference histochemical stains with structural boundaries on the biopsy.