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Identification of factors associated with the reversion of diagnosed case of DDH back to normal - Essay Example

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Summary
Developmental dysplasia of the hip (DDH) is a problem, usually, detected at the time of birth or after some weeks due to screening protocol prepared for it. If untreated some cases may revert back to normal after about 2-6 months but those who are remained as DDH they pose problems to the newborn when she/he starts walking…
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Identification of factors associated with the reversion of diagnosed case of DDH back to normal
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Moreover, as it has been evidenced that most of the diagnosed cases revert back to normal condition also proposes a question why should these patients treated when the situation may turn to normal To explore the association, between diagnosed cases of DDH who reverted back to normal and the characters possessed by these cases, a case control study is proposed to be carried out in Yorkhill, Royal Hospital for Sick Children. This study will explore the association between various characteristics and the cases of DDH reverted back.

The findings will be helpful in formulating a framework of analysis based on which the candidates with DDH will need treatment. This association will be seen through the analysis at multivariate level using SPSS software version 14.0. the association will be assessed by the risk ratios along with the confidence interval around the estimates. Over the last two decades much knowledge has been added to Developmental Dysplasia of the Hip (DDH) previously known as the congenital hip dislocation (CHD).

DDH affects the ball and socket type of hip joint when there is problem in fitting the head of the femur in the socket of the acetabulum. This fitting may be of different degree ranging from subluxatable, dislocateable or currently dislocated when examined (Developmental dysplasia of hip,Orth surg) (Fuloria 2002). The incidence rate of DDH is fairly high in the Europe and neighbouring areas. A study carried out in Dublin revealed an incidence of 3.2 per 1000 when screening was done by the ultrasonography (Lowry 2006).

While in Turkey, it was found that 4 out of 1000 not-at-risk boys presented with DDH; the rate was even higher for not-at-risk girls, 19 per 1000 girls (Akgun 2006). These studies were carried out for newborn babies. There are chances that these newborn may miss the diagnosis at birth and present late, after 6 months, frequency of late presentation is also not low; in Ireland 1.14 per 1000 children born during 1983-87 were presented late (Maxwell 2002). This condition poses a problem during walking if a newborn with DDH is missed the diagnosis.

The newborn walks by limping, toe walking or waddling (duck like gait). This causes severe physical disability as well as poses stigma to the growing child (Developmental dislocation hip, Amer Acade) (Developmental dysplasia hip Orth surg) (Bouchar).The associated risk factors are first born child, female sex, and breech presentation. It has been evidenced that female are more prone to this problem as compared to males and the ratio is 5-9 females for 1 male who are affected by this pathology.

DDH has been seen to present with left hip joint involvement than right hip joint. The reasons have not been explored as yet for the preponderance of the diseases in these situations (Developmental dislocation hip, Amer Acade) (Developmental dysplasia hip Orth surg). To fix the problem at an early stage a newborn is thoroughly examined by the paediatrician for DDH, along with routine examination, when she/he has got some risk factors involved or some findings are present at the time of first new born examination.

The further screening is performed with a consultation of an orthopaedic surgeon and if required a radiologist is also involved for

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