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Hip Disorder in Children and Adolescents: Diagnosis and Surgery
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Hip Disorder in Children and Adolescents: Diagnosis and Surgery

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Orthopedics".

Deadline for manuscript submissions: 1 September 2024 | Viewed by 4540

Special Issue Editor

Prof. Dr. Nicola Portinaro

E-Mail Website
Guest Editor
Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
Interests: hip; knees; foot and neurological orthopedic diseases and treatments

Special Issue Information

Dear Colleagues,

Hip disorders might be congenital, presenting at birth, or they might develop during early and/or late childhood. Although they all affect the same anatomical district, they are very different at clinical presentation, ranging from being almost asymptomatic to being very painful. In many cases, as in developmental dysplasia of the hip, they can be silent or mildly evident with an aspecific presentation on clinical examination. In other cases, as in Perthes disease, SUFE and FAI, they can be symptomatic. As such, the diagnosis of hip diseases might be challenging, but prompt and proper planned surgical treatment is particularly important.

This Special Issue of Children aims to highlight the most recent research findings related to this topic. Specifically, the present Special Issue welcomes original or review papers which will focus on the diagnosis, treatment and surgery of pediatric hip diseases to increase our understanding of these conditions and standardized or newly available treatment solutions, as well as sharing knowledge about incompletely understood and controversial areas in this field.

We look forward to receiving your contributions.

Prof. Dr. Nicola Portinaro
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • children
  • pediatric hip diseases
  • developmental hip dysplasia
  • perthes disease
  • slipped capital femoral epiphysis
  • femoroacetabular impingement
  • femoroacetabular deformity reconstruction

Published Papers (5 papers)

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10 pages, 1689 KiB  
Article
Transinguinal Ultrasound versus Magnetic Resonance in Spica Cast after Closed Reduction of Unstable Hips in DDH
by Nicola Guindani, Federico Chiodini and Maurizio De Pellegrin
Children 2024, 11(3), 292; https://doi.org/10.3390/children11030292 - 29 Feb 2024
Viewed by 723
Abstract
Background. During the treatment of unstable hips in developmental hip dysplasia (DDH), the position of the femoral head must be assessed in spica cast (SC) after reduction. A transinguinal sonographic technique (TIT) to the hip joint has been previously described in the literature. [...] Read more.
Background. During the treatment of unstable hips in developmental hip dysplasia (DDH), the position of the femoral head must be assessed in spica cast (SC) after reduction. A transinguinal sonographic technique (TIT) to the hip joint has been previously described in the literature. The aim of this study is to evaluate the agreement among TIT and MR to identify hip reduction. Methods. From 2016 to 2019, 14 consecutive newborns (10 female, 4 males) with a mean age of 2.97 ± 1.29 months were treated with closed reduction in SC. A total of 4/14 children had bilateral unstable DDH. Out of 18 hips, there were 8 hips type IV and 10 hips type IIIA, according to Graf. SC were changed monthly and hips were checked both with TIT and MR, looking for persistent dislocation. Results. Overall, a mean of 2.61 SC/hip (mode = 3) was accomplished, accounting for 47 procedures, with 46 reduced hips and 1 dislocated hip: TIT and MR always agreed on the same result (47/47; Cohen k = 1, CI95 1.00 to 1.00). Conclusions. The inguinal ultrasound technique described by van Douveren showed perfect agreement with MR and might be considered a reliable alternative to check the position of the femoral head during the conservative treatment of hip dysplasia in spica cast. Full article
(This article belongs to the Special Issue Hip Disorder in Children and Adolescents: Diagnosis and Surgery)
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12 pages, 4352 KiB  
Article
SUPERhip Reconstruction Treatment in Patients with Congenital Femoral Deficiency of Paley’s Classification Type 1b
by Francisco Hélio Violante Júnior, Fernando Farcetta Júnior, Douglas Manuel Carrapeiro Prina and Monica Paschoal Nogueira
Children 2024, 11(1), 75; https://doi.org/10.3390/children11010075 - 09 Jan 2024
Cited by 1 | Viewed by 674
Abstract
Background: Congenital femoral deficiency (CFD) is a challenging and complex condition that causes limb lengthening. We focused on the clinical and radiographic results of SUPERhip procedures in patients with congenital femoral deficiency type 1b, according to Paley’s classification, prior to femoral lengthening. Methods: [...] Read more.
Background: Congenital femoral deficiency (CFD) is a challenging and complex condition that causes limb lengthening. We focused on the clinical and radiographic results of SUPERhip procedures in patients with congenital femoral deficiency type 1b, according to Paley’s classification, prior to femoral lengthening. Methods: We reviewed all records and radiographs of patients who underwent this procedure between 2005 and 2020. We included 26 patients, with clinical and radiographic assessments performed during pre- and post-operative evaluations. Results: There were twenty-six patients (15 right vs. 11 left), with a mean age of 7 years (1–18). Most of the patients were female (17 patients; 65.4%). Twenty (76.9%) patients were undergoing their first procedure and six (23.1%) had already undergone a previous surgery. There was a significant improvement in all radiographic parameters, with the mean preoperative and postoperative Neck-Shaft Angle (NSA) being 72.3 ± 7.1° vs. 133.1 ± 12.7°, the Center-Edge Angle (CEA) 16.8 ± 9.8° vs. 33.5 ± 14.1°, and the Acetabular Index (AI) 27.8 ± 6.9° vs. 16.4 ± 6.8°, respectively. The complication rate was 15.4%, predominantly affecting patients under 5 years old. Conclusions: The SUPERhip procedure is an effective and reproducible technique for clinical and radiographic correction to a significant degree in patients with Paley’s type 1b CFD, in preparation for bone lengthening surgery. Full article
(This article belongs to the Special Issue Hip Disorder in Children and Adolescents: Diagnosis and Surgery)
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9 pages, 729 KiB  
Article
Bilateral Involvement in Developmental Dislocation of the Hip: Analysis of 561 Patients Operated on Using the Limited Posteromedial Approach
by Batuhan Gencer, Özgür Doğan and Ali Biçimoğlu
Children 2024, 11(1), 37; https://doi.org/10.3390/children11010037 - 28 Dec 2023
Viewed by 619
Abstract
Our objective was to scrutinize the risk factors related to bilateral involvement in the developmental dysplasia of the hip (DDH) and to inspect the impact of bilaterality on the enduring results of the DDH. All patients, aged between 6 and 18 months, who [...] Read more.
Our objective was to scrutinize the risk factors related to bilateral involvement in the developmental dysplasia of the hip (DDH) and to inspect the impact of bilaterality on the enduring results of the DDH. All patients, aged between 6 and 18 months, who underwent surgery using the limited posteromedial approach (734 hips from 561 patients), were included in this study. The number of births, birth type, history of consanguineous marriage, family history, and swaddling were analyzed. Physical examination and complaints of the patients were evaluated, and direct radiographs were examined in terms of the redislocation, avascular necrosis, and residual acetabular dysplasia. Among the 561 patients, bilateral DDH was observed in 173 patients (30.8%). The use of swaddling was found to be statistically significant between groups (p = 0.012). The use of swaddling for more than one month was associated with a higher odds ratio for bilaterality (p = 0.001, OR = 1.56, 95% CI: 1.2–2.0). Furthermore, bilaterality was associated with a higher risk for redislocation in DDH (p = 0.001, OR = 4.25, 95% CI: 1.6–11.2). The study concludes that swaddling for over a month is strongly linked with the bilateral involvement in DDH. It is important to note that bilaterality plays a crucial role in the development of redislocation after open reduction in DDH. Full article
(This article belongs to the Special Issue Hip Disorder in Children and Adolescents: Diagnosis and Surgery)
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10 pages, 1148 KiB  
Article
Long-Term Results after Chiari Pelvic Osteotomy in the Skeletally Immature and the Role of the Anti-Chiari Effect
by Eleonora Schneider, Marie-Christine Lutschounig, Klemens Vertesich, Markus Schreiner, Philipp Peloschek, Daniel Bork, Reinhard Windhager and Catharina Chiari
Children 2023, 10(10), 1593; https://doi.org/10.3390/children10101593 - 24 Sep 2023
Viewed by 820
Abstract
Several authors observed a loss of correction after performing Chiari pelvic osteotomy (CPO) in young patients. Hence, the aim of this study was to answer two questions: (1) Does the Chiari pelvic osteotomy affect the development of the acetabulum in skeletally immature patients [...] Read more.
Several authors observed a loss of correction after performing Chiari pelvic osteotomy (CPO) in young patients. Hence, the aim of this study was to answer two questions: (1) Does the Chiari pelvic osteotomy affect the development of the acetabulum in skeletally immature patients in the long term? (2) Is there any evidence of the previously described “Anti-Chiari” effect after a mean follow-up of 36 years? Data from 21 patients (27 hips) undergoing CPO before the age of 16 years were clinically assessed, and the evolution of radiological parameters over time was analyzed. The mean age at CPO was 11.2 years (±3; 4.4–15.7). The 20- and 30-year survival rates of the CPO were 100% and 92.6%, respectively. Mean postoperative medialization was 54% (±18; 23–99). The average osteotomy angle was 11° (±7; 2–28). No significant changes were found for the center-edge angle (CEA) and acetabular index (AI) over time; the angle of Idelberger and Frank (ACM) almost reached normal values at follow-up (FU); for the acetabular-head index (AHI), a slight shift toward the initial situation could be detected. The morphology of the acetabulum remained unchanged over time. The “Anti-Chiari effect” seems to be primarily caused by insufficient coverage of the femoral head rather than damage to the apophysis due to surgery. Full article
(This article belongs to the Special Issue Hip Disorder in Children and Adolescents: Diagnosis and Surgery)
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21 pages, 5025 KiB  
Systematic Review
Screening of Developmental Dysplasia of the Hip in Europe: A Systematic Review
by Wojciech Krysta, Patryk Dudek, Łukasz Pulik and Paweł Łęgosz
Children 2024, 11(1), 97; https://doi.org/10.3390/children11010097 - 13 Jan 2024
Viewed by 1190
Abstract
Background: Developmental dysplasia of the hip (DDH) is a prevalent orthopaedic disorder in children, and screening methods vary across regions due to local health policies. The purpose of this review is to systematise the different ultrasound screening strategies for detecting DDH in newborns [...] Read more.
Background: Developmental dysplasia of the hip (DDH) is a prevalent orthopaedic disorder in children, and screening methods vary across regions due to local health policies. The purpose of this review is to systematise the different ultrasound screening strategies for detecting DDH in newborns in Europe. Methods: Eligible studies from the PubMed, Embase, and Scopus databases, published between 1 January 2018 and 18 March 2023, were included. The inclusion criteria specified a European origin, a focus on newborn human patients, and information on ultrasound for DDH detection. Results: In total, 45 studies were included, covering 18 countries. Among them, six nations (Austria, Bosnia and Herzegovina, Poland, Slovenia, the Czech Republic, and Germany) perform universal ultrasound screening. The timing of the first ultrasound varies, with Austria and the Czech Republic within the 1st week, Bosnia and Herzegovina on the day of birth, Poland between 1 and 12 weeks, and Germany before the 6th week. The Graf method is the most popular ultrasound technique used. Conclusions: There is no consensus on the optimal DDH detection approach in Europe. Varied screening methods stem from epidemiological, cultural, and economic differences among countries. Full article
(This article belongs to the Special Issue Hip Disorder in Children and Adolescents: Diagnosis and Surgery)
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