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Ultrasonographic screening for developmental dysplasia of the hip: the Graf method revisited

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Abstract

Until the 1980s, the diagnosis of developmental dysplasia of the hip (DDH) was based on clinical examination and radiographic imaging. In 1980, Reinhard Graf developed his own ultrasonographic method for the examination of the infant hip joint. Graf’s method evaluates the osseous and cartilaginous coverage of the femoral head by the acetabulum in the infantile hip joint by measuring the angles α and β. The validity of Graf method is that with these measurements the hip joint is further classified by Graf classification into types I to IV that guide treatment. Currently, Graf method is considered the gold standard examination for the diagnosis of DDH in many European countries. This review article aims to discuss the incidence, risk factors and pathophysiology of DDH, and to emphasize on the Graf method for the evaluation, classification, prevention and further management of this entity.

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Authors and Affiliations

  1. Department of Orthopaedics, General Hospital of Larisa, Larisa, Greece

    Stylianos Kolovos

  2. First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Spyridon Sioutis, Dimitrios Serenidis, Pavlos Altsitzioglou, Vasileios Karampikas, Dimitrios Mastrokalos, Dimitrios Koulalis, Panayiotis J. Papagelopoulos & Andreas F. Mavrogenis

  3. Third Department of Paediatrics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Maria-Eleni Papakonstantinou

  4. Vioapeikonisi-Diagnostic Imaging Laboratory, Heraklion, Crete, Greece

    Konstantinos Chlapoutakis

  5. Department of Physical and Rehabilitation Medicine, Thoracic Diseases General Hospital Sotiria, Athens, Greece

    Evanthia Mitsiokapa

  6. Department of Emergency Medicine and Cardiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Spyridon Katsanos

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Kolovos, S., Sioutis, S., Papakonstantinou, ME. et al. Ultrasonographic screening for developmental dysplasia of the hip: the Graf method revisited. Eur J Orthop Surg Traumatol 34, 723–734 (2024). https://doi.org/10.1007/s00590-023-03767-9

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