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Is prematurity a risk factor for developmental dysplasia of the hip? : a prospective study
M M Orak1, T Onay2, S A Gümüştaş3
1Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Insights
Prematurity is not a risk factor for developmental dysplasia of the hip (DDH). This study found no significant difference in hip dysplasia incidence between preterm and full-term infants, suggesting prematurity does not predispose infants to DDH.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Neonatology
Background:
- Developmental dysplasia of the hip (DDH) is a common condition affecting infants.
- Prematurity is a potential risk factor for various infant health issues, but its role in DDH is debated.
Purpose of the Study:
- To investigate whether prematurity is a risk factor for developmental dysplasia of the hip (DDH).
Main Methods:
- A prospective study compared 221 preterm infants (born ≤34 weeks gestation) with 246 full-term infants.
- Infants were assessed using physical examination (Ortolani's, Barlow's tests) and Graf ultrasound within one week of corrected age.
- Both hips of all infants were evaluated for signs of dysplasia.
Main Results:
- A statistically significant difference was observed in the incidence of mature and immature hips between preterm and full-term infants (p < 0.001).
- The proportion of infants with an alpha angle < 60° differed significantly (p < 0.001).
- However, the incidence of pathological dysplasia (alpha angle < 50°) was not significantly different between the groups (p = 1.000), with Barlow sign present in 0.5% of preterm and 2.8% of full-term infants.
Conclusions:
- Prematurity is not a predisposing factor for developmental dysplasia of the hip (DDH).
- The study suggests that other factors, not prematurity itself, may be more influential in the development of DDH.
Abstract:
The aim of this prospective study was to investigate prematurity as a risk factor for developmental dysplasia of the hip (DDH). The hips of 221 infants (88 female, 133 male, mean age 31.11 weeks; standard deviation (sd) 2.51) who were born in the 34th week of gestation or earlier, and those of 246 infants (118 female, 128 male, mean age 40.22 weeks; sd 0.36) who were born in the 40th week of gestation, none of whom had risk factors for DDH, were compared using physical examination and ultrasound according to the technique of Graf, within one week, after the correction of gestational age to the 40th week after birth or one week since birth, respectively. Both hips of all infants were included in the study. Ortolani's and Barlow's tests and restricted abduction were accepted as positive findings on examination. There was a statistically significant difference between pre- and full-term infants, according to the incidence of mature and immature hips (p < 0.001). The difference in the proportion of infants with an α angle < 60° between the two groups was statistically significant (p < 0.001). The incidence of pathological dysplasia (α angle < 50 º) was not significantly different in the two groups (p = 1.000). The Barlow sign was present in two (0.5%) pre-term infants and in 14 (2.8%) full-term infants. These results suggests that prematurity is not a predisposing factor for DDH.
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