A nurse is assessing a newborn who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?
A.
Inwardly turned foot on the affected side
B.
Absent plantar reflexes
C.
Lengthened thigh on the affected side
D.
Asymmetric thigh fold
The Correct Answer and Explanation is:
The correct answer is D. Asymmetric thigh folds.
Explanation:
Developmental dysplasia of the hip (DDH) refers to a condition where the hip joint has not formed properly in infants and young children. This can range from a hip joint that is unstable to one that is completely dislocated. Recognizing the signs and symptoms of DDH is crucial for early intervention and management.
One of the hallmark signs of DDH is the asymmetric thigh folds. When a nurse assesses a newborn, they should look for differences in the skin folds of the thighs. In a healthy hip joint, the skin folds on both sides of the thigh should be symmetrical. However, in cases of DDH, the affected side may have fewer or more pronounced folds compared to the unaffected side due to the positioning of the femur and the effects of the dislocated joint on surrounding structures.
Other Options Explained:
- A. Inwardly turned foot on the affected side: While foot positioning can vary, it is not a primary indicator of DDH. The foot might appear normal or may be involved in other positional deformities but inward turning is not specific to DDH.
- B. Absent plantar reflexes: This finding is not typical of DDH. The plantar reflex is generally present in healthy newborns. An absent reflex could suggest neurological issues rather than hip dysplasia.
- C. Lengthened thigh on the affected side: This statement is misleading. In DDH, the affected thigh is often shorter due to the abnormal positioning of the femur. Lengthening would not be a characteristic finding.
In summary, when assessing a newborn for developmental dysplasia of the hip, the presence of asymmetric thigh folds is a key physical finding that should alert the nurse to the possibility of DDH. Early detection through thorough assessment can lead to timely interventions, reducing the risk of long-term complications such as hip pain and osteoarthritis later in life.