Öz
Amaç: Gelişimsel kalça displazisi (GKD) sık görülen ve erken tanı konulup tedavi edilirse başarılı sonuçlar alınabilen bir hastalıktır. Çalışmamızda GKD şüphesi dışında ki nedenlerle çocuk acil servisine başvuran 12-24 aylık çocuk hastaların çekilen pelvis grafileri incelenerek GKD rastlantısal insidansının tespit edilmesi amaçlandı.
Materyal ve Metot: Çalışmamıza 1 Mayıs 2016- 9 Mart 2017 tarihleri arasında hastanemiz çocuk acil servisine çeşitli nedenlerle başvuran 12-24 ay arası çocuk hastalar dahil edildi. Bu hastaların çekilen batın grafilerine dijital kayıt sisteminden ulaşılıp, grafiler incelendi. Ölçüm için kalça kadranları, shenton-menard hattı ve asetabular indeks açısı incelenerek tanı konuldu. Elde edilen verilerle GKD rastlantısal insidansı hesaplandı.
Bulgular: Toplamda 2044 değerlendirmeye alınan hastanın 152’sinde GKD varlığı tesbit edildi. GKD saptanan 152 hastanın 98’i kız,54’ü erkek idi. Bu hastaların 73’ünde bilateral kalçada patoloji görüldü. Patoloji saptanan 152 hastadan 23 hastanın patolojiden haberi yoktu. GKD tanısı alan hastaların %15.1 oranının GKD tanısı almadığı tespit edildi.
Kalça çıkığı olan hastalar cinsiyete göre göre karşılaştırıldığında pearson ki-kare testine göre p<0,001 olup kız çoçuklarında anlamlı olarak yüksek tespit edildi
Sonuç: GKD’li hastaların erken tanı alması ileri yaşlarda yaşayacakları geri dönüşümü olmayan kalça problemlerini ve ameliyatlarını önleyecektir. Acil hekimleri her ne şikayetle gelirse gelsin özellikle 2 yaş altı çocukların batın grafilerini incelerken GKD tanısı akıllarında bulundurmalıdırlar.
Anahtar Kelimeler
Gelişimsel kalça dispazisi doğumsal kalça çıkığı kalıcı asetabular displazi
Kaynakça
- 1. Hennrikus WL. Developmental dysplasia of the hip: Diagnosis and treatment in children younger than 6 months. Pediatric annals. 1999;28(12):740-746.
- 2. Herring J. Elsevier Health Sciences; 2013. Tachdjian’s Pediatric Orthopaedics E-Book: From the Texas Scottish Rite Hospital for Children[Google Scholar].
- 3. Doğruel H, Atalar H, Yavuz OY, Uraş İ, Günay C, Şayli U. Türkiye'de Gelişimsel Kalça Displazisi Sıklığının ve Tarama Programlarının Değerlendirilmesi. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2008;28(3):357-360.
- 4. Mahan ST, Kasser JR. Does swaddling influence developmental dysplasia of the hip? Pediatrics. 2008;121(1):177-178.
- 5. Bilgen S. Sarısözen B. Gelişimsel kalça displazisi Güncel Pediatri. 2005;2:18-21.
- 6. Gent E, Clarke N. Joint replacement for sequelae of childhood hip disorders. Journal of Pediatric Orthopaedics. 2004;24(2):235-240.
- 7. Noordin S, Umer M, Hafeez K, Nawaz H. Developmental dysplasia of the hip. Orthopedic Reviews. 2010;2(2).
- 8. Rosen A, Gamble JG, Vallier H, Bloch D, Smith L, Rinsky LA. Analysis of radiographic measurements as prognostic indicators of treatment success in patients with developmental dysplasia of the hip. Journal of pediatric orthopedics Part B. 1999;8(2):118-121.
- 9. Yilar S, Toy S, Kose M, Tuncer K, Ezirmik N, Aydın A, et al. Comparison of Open Reduction Alone and Open Reduction Plus Pemberton Osteotomy Techniques in the Treatment of Developmental Hip Dysplasia at Walking Age. The Eurasian Journal of Medicine. 2019;51(3):228.
- 10. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? World journal of orthopedics. 2015;6(11):886.
- 11. Mulpuri K, Schaeffer EK, Andrade J, Sankar WN, Williams N, Matheney TH, et al. What risk factors and characteristics are associated with late-presenting dislocations of the hip in infants? Clinical Orthopaedics and Related Research®. 2016;474(5):1131-1137.
- 12. Lindberg A, Bompadre V, Satchell E, Larson A, White K. Patient factors associated with delayed diagnosis of developmental dysplasia of the hip. Journal of Children's Orthopaedics. 2017;11(3):223-228.
- 13. Duramaz A, Peker G, Arslan L, Bilgili MG, Erçin E, Kural C. Gelişimsel Kalça Displazisi Tanısında Kalça Ultrasonografisi: Bakırköy Tecrübesi. Haseki Tıp Bülteni. 2014;52:262-267.
- 14. Vaquero-Picado A, González-Morán G, Garay EG, Moraleda L. Developmental dysplasia of the hip: update of management. EFORT open reviews. 2019;4(9):548-556.
- 15. Pavlik A, Peltier LF. The functional method of treatment using a harness with stirrups as the primary method of conservative therapy for infants with congenital dislocation of the hip. Clinical Orthopaedics and Related Research®. 1992;281:4-10.
Öz
Aim: Developmental dysplasia of hip (DDH) is a common disease that can be treated successfully if early diagnosis and treatment are possible. In our study, we aimed to determine the incidence of DDH by examining the pelvic radiographs of 12-24 months old children who were admitted to the pediatric emergency department for reasons other than suspicion of DDH.
Material and Method: Between May 1, 2016 and March 9, 2017, 12-24 months old children who were admitted to our pediatric emergency department for various reasons were included in the study. The abdominal radiographs of these patients were obtained from the digital recording system and the radiographs were examined. For measurement; hip quadrants, shenton-menard line and acetabular index angle were examined and used for diagnosis. The incidence of DDH was calculated with the data obtained.
Results: A total of 2044 patients were included in this study and 152 of them were diagnosed with DDH. Of the 152 patients with DDH, 98 were female and 54 were male. 73 of these patients had pathology in bilateral hips. Of the 152 patients with pathology, 23 had no information about this pathology. It was found that 15.1% of the patients diagnosed with DDH were not diagnosed with DDH. When hip dislocation was compared according to gender, pearson chi-square test was found to be p<0,001 and it was found to be significantly higher in girls.
Conclusion: The early diagnosis of patients with DDH will prevent the irreversible hip problems and surgeries in older ages. Emergency physicians should keep in mind the diagnosis of DDH, especially when examining the abdominal radiographs of children under 2 years of age, regardless of their complaints.
Anahtar Kelimeler
Developmental dysplasia of the hip congenital hip dislocation residual acetabular dysplasia.
Kaynakça
- 1. Hennrikus WL. Developmental dysplasia of the hip: Diagnosis and treatment in children younger than 6 months. Pediatric annals. 1999;28(12):740-746.
- 2. Herring J. Elsevier Health Sciences; 2013. Tachdjian’s Pediatric Orthopaedics E-Book: From the Texas Scottish Rite Hospital for Children[Google Scholar].
- 3. Doğruel H, Atalar H, Yavuz OY, Uraş İ, Günay C, Şayli U. Türkiye'de Gelişimsel Kalça Displazisi Sıklığının ve Tarama Programlarının Değerlendirilmesi. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2008;28(3):357-360.
- 4. Mahan ST, Kasser JR. Does swaddling influence developmental dysplasia of the hip? Pediatrics. 2008;121(1):177-178.
- 5. Bilgen S. Sarısözen B. Gelişimsel kalça displazisi Güncel Pediatri. 2005;2:18-21.
- 6. Gent E, Clarke N. Joint replacement for sequelae of childhood hip disorders. Journal of Pediatric Orthopaedics. 2004;24(2):235-240.
- 7. Noordin S, Umer M, Hafeez K, Nawaz H. Developmental dysplasia of the hip. Orthopedic Reviews. 2010;2(2).
- 8. Rosen A, Gamble JG, Vallier H, Bloch D, Smith L, Rinsky LA. Analysis of radiographic measurements as prognostic indicators of treatment success in patients with developmental dysplasia of the hip. Journal of pediatric orthopedics Part B. 1999;8(2):118-121.
- 9. Yilar S, Toy S, Kose M, Tuncer K, Ezirmik N, Aydın A, et al. Comparison of Open Reduction Alone and Open Reduction Plus Pemberton Osteotomy Techniques in the Treatment of Developmental Hip Dysplasia at Walking Age. The Eurasian Journal of Medicine. 2019;51(3):228.
- 10. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? World journal of orthopedics. 2015;6(11):886.
- 11. Mulpuri K, Schaeffer EK, Andrade J, Sankar WN, Williams N, Matheney TH, et al. What risk factors and characteristics are associated with late-presenting dislocations of the hip in infants? Clinical Orthopaedics and Related Research®. 2016;474(5):1131-1137.
- 12. Lindberg A, Bompadre V, Satchell E, Larson A, White K. Patient factors associated with delayed diagnosis of developmental dysplasia of the hip. Journal of Children's Orthopaedics. 2017;11(3):223-228.
- 13. Duramaz A, Peker G, Arslan L, Bilgili MG, Erçin E, Kural C. Gelişimsel Kalça Displazisi Tanısında Kalça Ultrasonografisi: Bakırköy Tecrübesi. Haseki Tıp Bülteni. 2014;52:262-267.
- 14. Vaquero-Picado A, González-Morán G, Garay EG, Moraleda L. Developmental dysplasia of the hip: update of management. EFORT open reviews. 2019;4(9):548-556.
- 15. Pavlik A, Peltier LF. The functional method of treatment using a harness with stirrups as the primary method of conservative therapy for infants with congenital dislocation of the hip. Clinical Orthopaedics and Related Research®. 1992;281:4-10.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Nisan 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 11 Sayı: 1 |
