Module 32, General Medical Level

A full term female infant was born by Cesarean-section because of slow progression of labor. The child was not breech and was noted to have a dislocatable hip at birth (Barlow and Ortolani negative). There was a negative family history of DDH. Abduction of the right hip was 80 degrees but left was only 60 degrees. There was a positive Galeazzi sign with the left hip being shorter than the right.

Question 32A

With no evidence of instability at birth this child is not likely to have a dislocated hip.

Question 32B

Further work up is indicated with the next test obtained being a hip xray.

Question 32C

The primary treatment of a fixed dislocation should completely resolve the problem with no long term consequence.

Question 32D

The negative Barlow and Ortolani signs are poor prognostic indicators for the response to Pavlik harness treatment.

Question 32E

When this child is seen initially at 10 days of age you would expect that surgical treatment will be required and would encourage the mother to get it scheduled soon.

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