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[Follow-up control of ultrasonographic neonatal screening of the hip]
B Schüle1, H Wissel, W Neumann
1Orthopädische Klinik und Poliklinik Heinrich-Heine-Universität Düsseldorf.
Insights
Early ultrasound screening for congenital hip dislocation (CDH) in newborns is crucial. Prompt treatment ensures normal hip development, with 97% of screened infants showing normal hip joints by four months.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Diagnostic Imaging
Background:
- Congenital hip dislocation (CDH) is a significant pediatric condition.
- Early diagnosis and intervention are critical for optimal outcomes.
- Ultrasound is a valuable tool for neonatal screening.
Purpose of the Study:
- To evaluate the efficacy of a general ultrasound screening program for early CDH diagnosis.
- To assess the treatment outcomes for diagnosed cases of hip dysplasia or dislocation.
- To determine the incidence of developmental dysplasia of the hip (DDH) requiring treatment in newborns.
Main Methods:
- A screening program involving ultrasound examination of 1656 newborns.
- Application of Graf's classification for hip joint assessment.
- Follow-up evaluation of hip joint development after treatment.
Main Results:
- 2.5% of newborns were diagnosed with hip dysplasia or dislocation requiring treatment.
- All treated cases achieved normal hip joint development.
- 11.3% of type IIa hips evolved to type IIb (Graf classification) by 12 weeks.
- 97% of all screened hip joints were normal by 4 months of age.
Conclusions:
- A universal ultrasound screening program for CDH is necessary.
- Early and appropriate treatment of CDH leads to normal hip development.
- Ultrasound screening effectively identifies infants requiring intervention for hip abnormalities.
Abstract:
1656 newborns were examined by ultrasound for early diagnosis of CDH in a screening program. In 2.5% of the cases, dysplasia or dislocation of the hip was diagnosed and required treatment. In all cases the final outcome after adequate treatment showed a hip joint without any abnormalities. 11.3% of type IIa-hips (using Graf's classification) did not reach an alpha-angle of 60 degrees until the 12th week. They were then therefore classified as type IIb. 97% of all hip joints were judged as normal in the course of the 4th month. This study emphasizes the necessity of a general ultrasound screening program. It also demonstrated that early and adequate treatment leads to a normal development of the joint.