Displasia do desenvolvimento do quadril – Parte 1

Susana Reis Braga; Amâncio Ramalho Júnior; Miguel Akkari; Marina Juliana Pita Sassioto Silveira Figueiredo; Gilberto Waisberg; Claudio Santili

doi:10.1055/s-0042-1758371

Revista Brasileira de Ortopedia, Table of Contents

CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(06): e839-e846
DOI: 10.1055/s-0042-1758371

Artigo de Atualização

Ortopedia Pediátrica

Displasia do desenvolvimento do quadril – Parte 1

Article in several languages: português | English

Susana Reis Braga

¹Médico assistente, Grupo de Ortopedia Pediátrica, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil

²Médico assistente, Grupo de Ortopedia Pediátrica, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil

,

Amâncio Ramalho Júnior

²Médico assistente, Grupo de Ortopedia Pediátrica, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil

,

Miguel Akkari

¹Médico assistente, Grupo de Ortopedia Pediátrica, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil

²Médico assistente, Grupo de Ortopedia Pediátrica, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil

,

Marina Juliana Pita Sassioto Silveira Figueiredo

³Médica ortopedista e traumatologista, Hospital Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil

,

Gilberto Waisberg

¹Médico assistente, Grupo de Ortopedia Pediátrica, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil

⁴Médico ortopedista e traumatologista, Grupo de Ortopedia e Traumatologia Pediatrica, Hospital Mario Covas, Faculdade de Medicina do ABC, Santo André, SP, Brasil

,

Claudio Santili

¹Médico assistente, Grupo de Ortopedia Pediátrica, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil

› Author Affiliations

Abstract

Resumo

O termo displasia do desenvolvimento quadril (DDQ) refere-se à condição na qual a articulação sofre alterações na sua formação durante os últimos meses da vida intrauterina ou nos primeiros meses após o nascimento. No espectro de apresentação, varia desde a instabilidade femuroacetabular, passando por estádios de displasia até a completa luxação. O diagnóstico precoce é fundamental para o sucesso do tratamento. A triagem através do exame clínico incluindo manobras apropriadas é imprescindível nos recém-nascidos e nas avaliações subsequentes durante o crescimento da criança.

O rastreamento ultrassonográfico é indicado nos bebês sob suspeita clínica e muito mais recomendável naqueles que tiveram apresentação pélvica para o parto ou que tenham antecedentes familiares. A ultrassonografia do quadril nos primeiros meses seguida da radiografia da bacia após o 4° ou 6° mês de vida são os exames que determinam o diagnóstico e auxiliam o seguimento.

O tratamento está baseado na obtenção de uma redução concêntrica e na manutenção e estabilização do quadril, propiciando a remodelação articular. Inicialmente, as órteses de flexão/abdução são a escolha; em crianças maiores pode ser necessário o uso de gesso após redução incruenta com ou sem tenotomia; redução aberta pode ser indicada e após os 18 meses as osteotomias pélvicas associadas a capsuloplastia e eventuais osteotomias acetabular e femoral.

Crianças tratadas devem ser acompanhadas durante todo o seu crescimento pelo eventual risco de displasias tardias.

Palavras-chave

displasia do desenvolvimento do quadril - luxação congênita de quadril - diagnóstico - tratamento

Full Text

References

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