Neonatal Incidence of Hip Dysplasia
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The advantages of sonographic examination are well known, but its main disadvantage is that it might lead to overdiagnosis, which might cause overtreatment. Variations in the incidence of developmental dysplasia of the hip are well known. We ascertained the incidence of neonatal sonographic developmental dysplasia of the hip without considering the development of those joints during followup. All 45,497 neonates (90,994 hips) born in our institute between January 1992 and December 2001 were examined clinically and sonographically during the first 48 hours of life. Sonography was performed according to Graf’s method, which considers mild hip sonographic abnormalities as Type IIa. We evaluated the different severity type incidence pattern and its influence on the total incidence during and between the investigated years. According to our study, sonographic Type IIa has major effects on the incidence of overall developmental dysplasia of the hip with a correlation coefficient of 0.95, whereas more severe sonographic abnormalities show relatively stable incidence patterns.
Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
KeywordsDevelopmental Dysplasia Sonographic Examination Incidence Pattern Sonographic Abnormality Graf Type
We thank Mrs Myrna Perlmutter for her help in the preparation of the manuscript and Mrs Ronit Leiba for help with the statistical analysis. We are very grateful to the medical staff of the Neonatal Unit who performed all the routine clinical examinations.
- 1.Barlow TG. Early diagnosis and treatment of congenital dislocation of the hip. J Bone Joint Surg Br. 1962;44:292–301.Google Scholar
- 6.Edelstein J. Congenital dislocation of the hip in Bantu. J Bone Joint Surg Br. 1966;48:397.Google Scholar
- 9.Ganger R, Grill F, Leodolter S. Ultrasound screening of the hip in newborns: results and experience. J Pediatr Orthop. 1988;8:12–16.Google Scholar
- 10.Graf R. Guide to Sonography of the Infant Hip. Stuttgart, Germany: George Thieme Verlag; 1987.Google Scholar
- 11.Graf R, Tschauner C, Klapsch W. Progress in prevention of late developmental dislocation of the hip by sonographic newborn hip ‘screening’: results of a comparative follow-up study. J Pediatr Orthop. 1988;8:12–16.Google Scholar
- 18.Lotito FM, Riccio R, Peluso M, Giustardi A. Ultrasound screening for neonatal dysplasia of the hip. Riv Ital Pediatr. 1990;16:657–661.Google Scholar
- 20.Patel H. the Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update: screening, management of the hip in newborns. CMAJ. 2001;164:1669–1677.Google Scholar
- 22.Reibel T, Herzig N, Nasir R. Neonatales Huft-Screening. Monatsschr Kinderheilkd. 1995;143:268–273.Google Scholar
- 23.Reibel T, Nasir R, Kaeding M, Eckart L. Worsening found by continuous observation of the hip joints in neonatal screening. Monatsschr Kinderheilkd. 1990;138:664–669.Google Scholar
- 26.Svec A, Kokavec M. Sonograficky skrining—moderny trend v prevencii vyvojovej dysplazie koxy. Detsky Lekar Marec. 2001;46:34–38.Google Scholar
- 28.Tachdjian MO. Congenital dysplasia of the hip. In: Tachdjian MO, ed. Pediatric Orthopedics. Vol 1, 2nd ed. Philadelphia, PA: WB Saunders; 1990:297–526.Google Scholar
- 31.Weinstein SL. Developmental hip dysplasia, dislocation. In: Morrissy RT, Weinstein SL, eds. Lovell and Winter’s Pediatric Orthopaedics. 4th ed. Philadelphia, PA: Lippincott-Raven; 1996:903–943.Google Scholar