Page 1131 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 39

Musculoskeletal Problems

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Priority Concepts
Development; Mobility

I. Developmental Dysplasia of the Hip
A. Description
1. Problems related to abnormal development of the hip
that may develop during fetal life, infancy, or
childhood; in these problems, the head of the femur is
seated improperly in the acetabulum, or hip socket, of
the pelvis.
2. Degrees of developmental dysplasia of the hip (Box
39-1)

B. Assessment (Fig. 39-1)

1. Neonate: Laxity of the ligaments around the hip
2. Infant
a. Shortening of the limb on the affected
side (Galeazzi sign, also known as Allis
sign)
b. Restricted abduction of the hip on the
affected side when the infant is placed
supine with knees and hips flexed
(limited range of motion in the affected
hip)
c. Unequal gluteal folds when the infant is
prone and legs are extended against
the examining table
d. Positive Ortolani’s test: Ortolani’s
maneuver is a test to assess for hip
instability. The examiner abducts the
thigh and applies gentle pressure
forward over the greater trochanter. A
“clicking” sensation indicates a
dislocated femoral head moving into
the acetabulum.
e. Positive Barlow’s test: The examiner

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