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[Our three-year experience with an ultrasonographic hip screening program conducted in infants at 3 to 4 weeks of
Nüsret Köse1, Hakan Omeroğlu, Bülent Ozyurt
1Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Osmangazi University, Eskişehir, Turkey.
Insights
Ultrasonographic hip screening effectively diagnoses developmental dysplasia of the hip (DDH) in newborns, enabling early treatment. However, program attendance remains a challenge, with many infants missing scheduled screening appointments.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Public Health
Background:
- Developmental dysplasia of the hip (DDH) is a common congenital condition requiring early detection.
- Ultrasonography is a valuable tool for screening and diagnosing DDH in infants.
- Implementing a newborn screening program is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the effectiveness of a newborn ultrasonographic hip screening program.
- To assess the utility and feasibility of this screening program in Turkey.
- To determine the early diagnosis and treatment success rates for DDH.
Main Methods:
- A three-year prospective study involving 1440 newborns and their parents.
- Parents received detailed information about DDH and risk factors within 48 hours of birth.
- Infants underwent clinical and ultrasonographic hip examinations at 3-4 weeks of age.
Main Results:
- 975 infants (67.7%) attended the screening; 85.3% had normal hips (Graf type I).
- 1.2% of hips required immediate treatment (type IIc, D, or IIIa), with successful outcomes after 8 weeks.
- 3.6% of infants (45 hips) were treated, primarily with a Pavlik harness; 28.6% had risk factors, most commonly a positive family history.
Conclusions:
- Ultrasonographic hip screening at 3-4 weeks is effective for early DDH diagnosis and treatment.
- High infant attendance rates are essential for program success.
- Challenges in program feasibility include parental availability for scheduled appointments.
Objectives:
The aim of this study was to evaluate the results of a newborn ultrasonographic hip screening program conducted at 3-4 weeks of life, and to assess its utility and feasibility in Turkey.
Methods:
During a three-year period, parents of 1440 newborns were interviewed within 48 hours following birth to be informed in detail about developmental dysplasia of the hip (DDH) and its risk factors. They were asked to bring their infants for clinical and ultrasonographic examinations of the hips 3 to 4 weeks after birth.
Results:
A total of 975 infants (67.7%; 488 girls, 487 boys; mean age 26 days; range 17 to 34 days) were available on the day of screening. According to the Graf's classification, 1664 hips (85.3%) were considered type I. Immediate treatment was initiated for 22 hips (1.2%) which were considered type IIc, D, or IIIa. All but one hip were found to be type I after eight weeks of treatment. Among type IIa hips with a complete follow-up, 12% required treatment. In total, 45 hips (2.3%) of 35 infants (3.6%) were treated preferably with a Pavlik harness. Of these, 10 infants (28.6%) had at least one risk factor for DDH, the most common being a positive family history (n=7, 20%). Of 45 treated hips, 12 hips (26.7%) exhibited positive clinical findings, the most common being asymmetry of the thigh/inguinal folds.
Conclusion:
Ultrasonographic hip screening program conducted at the age of 3 to 4 weeks is effective for early diagnosis and successful treatment of DDH. However, nearly one-thirds of the infants were not available at the appointed date, despite transmission of detailed information to the parents just after birth.
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