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Ultrasound in developmental dysplasia of the hip: A screening study in Sardinian newborns
A Dessì1, M Crisafulli, E Vannelli
1Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, University of Cagliari, Cagliari, Italy.
Insights
Early ultrasound screening for developmental dysplasia of the hip (DDH) in newborns is crucial. Prompt treatment based on Graf classification significantly improves hip development, especially for type 2a cases.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Developmental Biology
Background:
- Developmental dysplasia of the hip (DDH) is the most common congenital locomotor disorder.
- Early diagnosis is critical as the preclinical period for intervention is brief.
- Timely therapeutic intervention positively impacts DDH outcomes.
Purpose of the Study:
- To evaluate the effectiveness of ultrasound screening for DDH in a Sardinian neonatal population.
- To assess treatment outcomes based on Graf classification.
- To determine the value of ultrasonography in guiding DDH management.
Main Methods:
- Ultrasound examinations of both hips were performed on 1158 neonates using Graf's classification.
- Retrospective analysis identified congenital hip dislocation cases.
- Treatment outcomes were determined for all classified cases.
Main Results:
- 145 hips in 122 children required treatment for DDH, diagnosed between 14 days and 3 months.
- 94% of infants with type 2a hips showed normal ultrasound findings after one month of treatment with abduction splints.
- Other types (2b, 2c, D, 3) also responded well to splinting; type 4 hips were referred to specialists.
Conclusions:
- Ultrasonographic techniques, when performed by skilled operators, are highly valuable for DDH treatment prescription.
- Early diagnosis and treatment of DDH, particularly severe congenital dislocation, lead to satisfactory prognoses.
- Routine hip screening programs are advisable for early DDH diagnosis and effective management.
Introduction:
Developmental dysplasia of the hip (DDH) is the most frequent inborn deformity of the locomotor apparatus. Ultrasound screening is frequently used to identify DDH in view of the brevity of the preclinical period during which diagnosis is possible. Appropriate therapeutic intervention during this period can positively affects the evolution of the disorder.
Methods:
An unselected population of 1158 Sardinian neonates underwent ultrasound examinations of both hips, and findings were classified according to the method described by Graf. Patients were assessed by means of retrospective analysis to reveal cases of congenital dislocation of the hip joint. All cases were classified and treatment outcomes determined.
Results:
A total of 145 hips requiring treatment were observed in 122 children. Hip dysplasia and/or dislocation were diagnosed between the ages of 14 days and 3 months. One month after diagnosis ultrasound findings were normal in 94% of the infants with at least one hip classified as type 2a. The remaining 6% were classified as types 2b, 2c, D, and 3. All were treated with abduction splints, and normal hip development was observed after one or two months of treatment. Type 4 hips were referred to an orthopedic surgeon for specialist treatment.
Conclusions:
When performed by skilled operators, ultrasonographic techniques are of considerable value in prescribing treatment for DDH. The satisfactory prognosis associated with early treatment of severe congenital dislocation of the hip joint underlines the advisability of scheduling routine hip screening programs to ensure early diagnosis and effective treatment of the disorder.
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