DISLOCATION OF THE HIP IN CHILDREN WITH DOWN'S SYNDROME

GIUSEPPE SELVA, M.D., Pediatric Orthopaedic Research Fellow

FREEMAN MILLER, M.D., Attending Pediatric Orthopaedic Surgeon

July 25, 1995

CLINICAL CASE PRESENTATION

ORTHOPAEDIC DEPARTMENT

THE ALFRED I. DUPONT INSTITUTE

WILMINGTON, DELAWARE

CASE HISTORY:

PATIENT 1.

PATIENT 2.

DISEASE PROGRESSION:(Bennet et al, 1982)
  1. Initial phase (0-2 years).
  2. Dislocation phase (2 -10 years).
  3. Subluxation phase
  4. Fixed phase
SELECTED LITERATURE REVIEW:


REPORTED POPULATION:


   Reference             Patients and age             % sublux / dislocate            





 Diamond et al.      265 Pts          Children               4.5%           

        1981         +Adults                                                



 Bennet et. al.      220 Pts.         5 to 62                4.5%            

        1982         y.o.                                                   



 Aprin et al.        946 Pts          childhood              1.3%            

        1985         *                                                      



 Hresko et al.       65 Pts           14 to 70               18%             

        1993         y.o.                                                   




*review of records of children with Down S. registered at Children's Hospital of Boston (age 3 to 13).

TREATMENT RECOMMENDATIONS:
OUTCOME EXPECTATIONS:
REFERENCES:

1) Aprin H., Zink W. P., Hall J. E. Management of dislocation of the hip in Down Syndrome. J. Pediatr. Orthop. 5: 428; 1985

2) Bennet G.C., Rang M., Roye D. P., Aprin H. Dislocation of the hip in trisomy 21. J. Bone Joint Surg. 64-B: 289; 1982

3) Diamond L.S., Lynne D., Sigman B. Orthopedic disorders in Down's Syndrome. Orthop. Clin. North Am. 12: 57; 1981

4) Gore D. R. recurrent dislocation of the hip in a child with Down's Syndrome. A case report. J. Bone Joint Surg. 63-A: 823; 1981

5) Hrenko M.T., McCarthy J. C., Goldberg M.J. Hip disease in adults with Down Syndrome. Journal Bone Joint Surg. 75-B: 604; 1993

6) Shaw E. D., Beals R. K. The hip joint in Down's Syndrome. Clin. Orthop. 278:101; 1992

7) Skoff H.D., Keggi K. Total hip replacement in Down's Syndrome. Orthopedics 10:485; 1987.