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DEVELOPMENTAL DYSPLASIA of the HIP PASCA OSTEOMIELITIS NEONATUS

ELIZABETH THEA R, Dr. dr. Ida Safitri L, Sp.AK; dr. Tunjung Wibowo, M.Kes, SpAK

2021 | Tesis-Spesialis | ILMU KESEHATAN ANAK

Neonatus berusia 14 hari dirujuk ke NICU dari rumah sakit tersier dengan sepsis awitan lambat dan edema generalisata. Pasca perawatan beberapa hari, edema sekitar pelvis kiri tidak membaik dan pasien selalu teriritasi untuk prosedur sederhana seperti penggantian diaper. Pasca diskusi dengan beberapa departemen dan melakukan berbagai pemeriksaan penunjang, pasien didiagnosis dengan osteomielitis femur kiri proksimal dengan perluasan septik artritis pada pelvis. Septik artritis dan osteomielitis berhasil diterapi namun sayangya terjadi sekuelae developmental dysplasia of the hip (DDH). Penanganan kolaboratif dilakukan sejak awal terutama antara departemen pediatri dan ortopedi. Berbagai terapi reduksi (Pavlik harness, Ilfeld splint and hand-knee foot orthosis) secara berturutan dilakukan pasca pemasangan gips sembari dilakukan pengawasan berkala perkembangan saat reduksi pelvis dilakukan menggunakan skrining Denver II. Pasien mengalami keterlambatan pada area motorik kasar selama periode waktu tertentuk namun berhasil mengejar keterlambatan pasca ortosis dilepas sementara.

Fourteen days neonate was referred to NICU of tertiary hospital with late onset sepsis and generalized edema. After few days of hospitalization, edema over left hip did not improve and patient always irritated for simple procedure such as changing diapers. After discussion with various departments and various supporting examination was done, the patient was diagnosed with osteomyelitis of the proximal femur with extended associated septic arthritis of the hip. The septic arthritis and osteomyelitis successfully treated but nfortunately developmental dysplasia of the hip occurred as sequelae. Collaborative management was done since the beginning especially between pediatric and orthopedic department. Various reduction therapy (Pavlik harness, Ilfeld splint and hand-knee foot orthosis) had been done subsequently followed after plaster cast while continuous monitoring using Denver II screening also done for certain period of time along the hip management. The patient had suffered delay in gross motor area for certain period of time but managed to catch-up after removal of orthosis temporarily.

Kata Kunci : develomental dysplasia; osteomeilitis; neonatal

  1. SPESIALIS-2021-420558-abstract.pdf  
  2. SPESIALIS-2021-420558-bibliography.pdf  
  3. SPESIALIS-2021-420558-tableofcontent.pdf  
  4. SPESIALIS-2021-420558-title.pdf