Slide 012 — DDH treatment complications and AVN

Clean FRCS notes with inline figures

AVN hip in DDH

**Fig 1.** Radiograph / imaging - AVN radiographtop left

Diagnosis by Salter’s criteria. Any one of the following:

•Failure of formation or growth of ossific nucleus 1 yr after reduction

•Broad femoral head

•Increase density and fragmentation of head

•Residual deformity after ossification

•AVN

Kalamchi and McEwen classification 1-4

•1 mild with delayed ossification

•2 lateral, valgus deformity

•3 central, shortening

•4 complete, varus deformity

•Risk: Pavlik harness – 1-5%

•CR + hip spica – 10%

•OR up to 30%

Differential diagnosis

•MED

•Perthes

•Infection

•PFFD

Direct Q&A

Q1 What diagnostic or radiographic findings support DDH treatment complications and AVN?

AVN hip in DDH

Diagnosis by Salter’s criteria. Any one of the following:

•Failure of formation or growth of ossific nucleus 1 yr after reduction

•Broad femoral head

•Increase density and fragmentation of head

•Residual deformity after ossification

•AVN

Kalamchi and McEwen classification 1-4

•1 mild with delayed ossification

•2 lateral, valgus deformity

Q2 How is DDH treatment complications and AVN classified here?

•Failure of formation or growth of ossific nucleus 1 yr after reduction

•Broad femoral head

•Increase density and fragmentation of head

•Residual deformity after ossification

•AVN

Q3 What are the differential diagnoses for DDH treatment complications and AVN?

MED

•Perthes

•Infection

•PFFD

Raw speaker-note hierarchy audit

#	lvl	marL	indent	logical	original note line
1	0	None	None	0	AVN hip in DDH
2	0	0	0	0	Diagnosis by Salter’s criteria. Any one of the following:
3	0	171450	-171450	1	Failure of formation or growth of ossific nucleus 1 yr after reduction
4	0	171450	-171450	1	Broad femoral head
5	0	171450	-171450	1	Increase density and fragmentation of head
6	0	171450	-171450	1	Residual deformity after ossification
7	0	0	0	0	AVN
8	0	0	0	0	Kalamchi and McEwen classification 1-4
9	1	457200	0	1	1 mild with delayed ossification
10	1	457200	0	1	2 lateral, valgus deformity
11	1	457200	0	1	3 central, shortening
12	1	457200	0	1	4 complete, varus deformity
13	0	0	0	0	Risk: Pavlik harness – 1-5%
14	0	0	0	0	CR + hip spica – 10%
15	0	0	0	0	OR up to 30%
16	0	0	0	0	Ddx
17	0	171450	-171450	1	MED
18	0	171450	-171450	1	Perthes
19	0	171450	-171450	1	Infection
20	0	171450	-171450	1	PFFD

lvl

marL

indent

logical

original note line

None

AVN hip in DDH

Diagnosis by Salter’s criteria. Any one of the following:

171450

-171450

Failure of formation or growth of ossific nucleus 1 yr after reduction

171450

-171450

Broad femoral head

171450

-171450

Increase density and fragmentation of head

171450

-171450

Residual deformity after ossification

AVN

Kalamchi and McEwen classification 1-4

457200

1 mild with delayed ossification

457200

2 lateral, valgus deformity

457200

3 central, shortening

457200

4 complete, varus deformity

Risk: Pavlik harness – 1-5%

CR + hip spica – 10%

OR up to 30%

Ddx

171450

-171450

MED

171450

-171450

Perthes

171450

-171450

Infection

171450

-171450

PFFD

Improved semantic hierarchy used for the study notes

#	semantic level	section?	rewritten line
1	0		AVN hip in DDH
2	0	yes	Diagnosis by Salter’s criteria. Any one of the following:
3	1		Failure of formation or growth of ossific nucleus 1 yr after reduction
4	1		Broad femoral head
5	1		Increase density and fragmentation of head
6	1		Residual deformity after ossification
7	1		AVN
8	0	yes	Kalamchi and McEwen classification 1-4
9	1		1 mild with delayed ossification
10	1		2 lateral, valgus deformity
11	1		3 central, shortening
12	1		4 complete, varus deformity
13	1		Risk: Pavlik harness – 1-5%
14	1		CR + hip spica – 10%
15	1		OR up to 30%
16	0	yes	Differential diagnosis
17	1		MED
18	1		Perthes
19	1		Infection
20	1		PFFD

semantic level

section?

rewritten line

AVN hip in DDH

yes

Diagnosis by Salter’s criteria. Any one of the following:

Failure of formation or growth of ossific nucleus 1 yr after reduction

Broad femoral head

Increase density and fragmentation of head

Residual deformity after ossification

AVN

yes

Kalamchi and McEwen classification 1-4

1 mild with delayed ossification

2 lateral, valgus deformity

3 central, shortening

4 complete, varus deformity

Risk: Pavlik harness – 1-5%

CR + hip spica – 10%

OR up to 30%

yes

Differential diagnosis

MED

Perthes

Infection

PFFD

012. DDH treatment complications and AVN

Clean FRCS notes with inline figures

AVN hip in DDH

Diagnosis by Salter’s criteria. Any one of the following:

Kalamchi and McEwen classification 1-4

Differential diagnosis

Direct Q&A

AVN hip in DDH

Diagnosis by Salter’s criteria. Any one of the following:

Kalamchi and McEwen classification 1-4

MED

Raw speaker-note hierarchy audit

Improved semantic hierarchy used for the study notes