title: [Developmental dysplasia of the hip in children with a psychomotor disorder. A risk factor for a poor outcome?].
abstract: BACKGROUND
  Orthopaedic treatment of developmental dysplasia of the hip (DDH) has a high success rate in cases that are diagnosed early. However, the outcomes of these patients are not really known when they are subsequently diagnosed with some type of cerebral impairment.
  
  
  METHODS
  A retrospective observational study was conducted on cases of DDH with a poor outcome after orthopaedic treatment, being unknown if they had any type of psychomotor disorder. The patients were clinically and radiologically assessed, and afterwards received neurological valuation by the Child Neurology Unit.
  
  
  RESULTS
  Of the 325 cases of DDH diagnosed in 293 patients, 10 patients (3%) with 16 hips with DDH were diagnosed of any cerebral impairment. All them were initially treated orthopedically. Clinical and radiologically evolution was succesful only in 4 cases (25%) being necessary any surgical procedure in the remaining 12 cases. After surgical treatment we got an improvement in the Acetabular Index (p=0.005) and Reimers Extrusion Index (p=0.042). Neck-shaft angle and Wiberg CE angle also improved but this difference was not statically significant. Cerebral impairment was diagnosed at 2,5 years of age and the begining of walking was delayed at 2.4 years of age.
  
  
  CONCLUSIONS
  Cerebral impairment can lead to an unfavourable outcome in the treatment of DDH, with the relative risk of a poor outcome being 7.2 times higher in these patients. An unfavourable outcome with conventional treatment of DDH must make us suspect the presence of some type of neurological disorder, particularly if there is a delay in walking.
authors.affiliation: Servicio de COT, Hospital de Cabueñes, Gijón, Asturias, España. Electronic address: ivanpipa85@gmail.com.
authors.forename: Iván
authors.initials: I
authors.lastname: Pipa-Muñiz
authors.affiliation: Unidad COT Infantil Hospital Teresa Herrera, La Coruña, España.
authors.forename: María
authors.initials: M
authors.lastname: de Los Llanos Rodríguez-Rodríguez
authors.affiliation: Unidad Neurología Infantil Hospital Teresa Herrera, La Coruña, España.
authors.forename: M Blanca
authors.initials: MB
authors.lastname: Felgueroso-Juliana
authors.affiliation: Servicio de COT, Hospital de Cabueñes, Gijón, Asturias, España.
authors.forename: Manuela
authors.initials: M
authors.lastname: Riera-Campillo
authors.affiliation: Unidad COT Infantil Hospital Teresa Herrera, La Coruña, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: González-Herranz
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006618:Hip Dislocation, Congenital / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011596:Psychomotor Disorders / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cerebral impairment; Cerebral palsy; Developmental dysplasia of the hip; Displasia del desarrollo de la cadera; Parálisis cerebral infantil; Trastorno psicomotor