developmental dysplasia of hip (ddh) in prader-willi syndrome (pws)
TRANSCRIPT
Developmental Dysplasia of Hip in Prader-Willi Syndrome- Detection & Treatment
Kyungjei Woo
Dept. of Orthopedic SurgerySamsung Medical Center
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Musculoskeletal Abnormalities
• Scoliosis & Kyphosis – Scoliosis : 63.9 %
• Mean Cobb angle – 15.1°
• Thoracic : 6
• Thoracolumbar : 8
• Lumbar : 4
• Double curve : 6
– Kyphosis : 16.7 %• Mean kyphotic angle – 30.8°
(Shim et al. Journal of Pediatric Orthopaedics, 2010)
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Musculoskeletal Abnormalities
• Foot Abnormalities– Bilateral pes planus : 36.1 % – Bilateral pes cavus – Metatarsus adductus – Bilateral hallux valgus
(Shim et al. Journal of Pediatric Orthopaedics, 2010)
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• Incidence– DDH : 0.1%
DDH in PWS
10 % (X 100) West et al. Journal of Pediatric Orthopaedics 2004
~22.2 % (X 200) Shim . Journal of Pediatric Orthopaedics, 2010
DDH in PWS
10 % (X 100) West et al. Journal of Pediatric Orthopaedics 2004
~22.2 % (X 200) Shim . Journal of Pediatric Orthopaedics, 2010
Developmental Dysplasia of the Hip
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Phenomenon of combined disease– Torticolis– Adductus metatarsus– Plagiocephaly
Developmental Dysplasia of the Hip
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Diagnosis
• Clinical Diagnostic Test– Ortolani & Barlow : clunk
• Reduction & Provocation test
– Limitation of Range of Motion• Abduction
– Leg Length Discrepancy• Galeazzi sign or Allis sign
– Skin Crease
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Diagnosis
• Clinical Diagnostic Test– Ortolani & Barlow : clunk
• Reduction & Provocation test
– Limitation of Range of Motion• Abduction
– Leg Length Discrepancy• Galeazzi sign or Allis sign
– Skin Crease
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– Static assessment• Inter-observer & intrao-bserver variations
– Dynamic assessment• Ortolani & Barlow test
• Operator dependent
• Subjective assessment
Diagnosis - US
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