Nursing 209

N209: Reproductive Health Study Guide

6.5 Musculoskeletal Disorders Congenital Hip Dysplasia • Dislocation of the hip joint present at birth • Also referred to as developmental dysplasia of the hip (DDH) • Incidence: o Occurs in 1:1000 live births; more common in native American and Laplanders o Ten times greater incidence in children with parents with DDH o Females are 80% of those diagnosed with DDH; it is also common in the first born o May occur congenitally or any time after birth; etiology is unknown o 20% of breech presentations have presence of DDH o DDH in females born in breech presentation estimated to be 1:15 in some studies • Diagnosis: Made in newborn period via the “Ortolani Maneuver” (click is felt when the hip is reduced into the acetabulum with the hip in abduction) • One hip is examined at a time • Treatment: If the patient is younger than six months, bracing is done with Pavlik harness o If older than six months when diagnosis is made or if bracing is ineffective, closed reduction is recommended with or without traction before o If older than two or closed reduction fails, open reduction is considered o Hip spica cast is utilized following surgery to maintain proper hip position Muscular Dystrophy • Group of genetic disorders that result in progressive muscle weakness and loss • Consists of more than 30 genetic diseases • Who is affected, the muscles involved, and the presenting symptoms will all depend upon the type of MD • All types worsen as muscles weaken • Most of those affected will lose the ability to walk • Treatment is aimed at preventing complications o Includes speech and physical therapy, medications, surgery, and orthopedic device assistance • Duchenne Muscular Dystrophy is the most common form in children, and affects 1:5700 to 7700 males each year in the U.S. • Diagnosis: o Evaluation of serum creatine kinase: Released when muscle deterioration is present o Muscle biopsy: For genetic evaluation, along with genetic testing o Genetic testing: Look for missing or repeated mutations in dystrophin gene (if missing, diagnosed with Duchenne or Beck MD)

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