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Developmental dysplasia of the hip: prevalence based on ultrasound diagnosis
K Rosendahl1, T Markestad, R T Lie
1Department of Pediatric Radiology, University Hospital, N-5021 Bergen, Norway.
Insights
Developmental dysplasia of the hip (DDH) is more common in girls. Risk factors include family history and breech delivery, particularly in females. Hip morphology strongly correlates with sonographic stability.
Area of Science:
- Pediatrics
- Orthopedics
- Diagnostic Imaging
Background:
- Developmental dysplasia of the hip (DDH) is a common congenital disorder.
- Early diagnosis and management are crucial for preventing long-term complications.
Purpose of the Study:
- To determine the prevalence of hip morphology in newborns.
- To investigate the association between hip morphology and gender.
- To identify risk factors for DDH.
Main Methods:
- Sonographic evaluation of hip morphology using a modified Graf's method in 3613 newborns.
- Stability assessment using a Barlow equivalent maneuver.
- Analysis of risk factors including gender, family history, and delivery type.
Main Results:
- Girls exhibited higher rates of immature and dysplastic hips compared to boys.
- A family history of DDH and breech delivery were significant risk factors, especially for girls.
- Strong correlation observed between hip morphology and sonographic stability (gamma = 0.98).
Conclusions:
- Gender and family history are key factors in DDH prevalence.
- Breech delivery poses a specific risk for girls.
- Sonographic assessment provides reliable evaluation of hip stability.
Abstract:
The prevalence of sonographically normal, immature and dysplastic hips, the association between hip morphology and gender, and known risk factors for developmental dysplasia of the hip (DDH) were determined for 3613 randomly selected, healthy newborns. Hip morphology was determined according to a modified Graf's method, and stability was evaluated using a Barlow equivalent maneuver. A higher proportion of girls than boys had immature hips [16.9 % vs 9.3 %; relative risk (RR) = 2.0, 95 % confidence interval (CI) = 1.6-2.4], minor dysplasia (4.5 % vs 1.0 %; RR = 4.8, 95 % CI = 2.9-8.1), and major dysplasia (1.2 % vs 0.2 %; RR = 5.5, 95 % CI = 1.9-16.2). An increased risk was associated with having a sibling or parent with DDH (RR = 2.2, 95 % CI = 1.0-4.6 and RR = 3.6, 95 % CI = 1.1-12.5 for girls and boys, respectively), but not with DDH in more distant relatives. Breech delivery represented a significant risk factor only for the girls (RR = 2.2, 95 % CI = 1.1-4.4). There was a strong association between hip morphology and sonographic stability (gamma = 0.98).