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Ultrasound screening for developmental dysplasia of the hip in the newborn: a population-based study in the Maribor region, 1997–2005

Ultraschall-Screening bei Neugeborenen zur Diagnose der kongenitalen Hüftdysplasie: eine populationsbasierte Studie im Raum Maribor, 1997–2005

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Zusammenfassung

ZIEL: Der bildgebende Ultraschall ist eine anerkannte Methode für die Diagnose der Entwicklungs-Dysplasie der Hüfte (EDH) bzw. für das Management dieser Erkrankung. Ziel der vorliegenden Studie war es, die Ergebnisse der Daten des Neugeborenen-Screening-Programms, welches in Marburg von 1997–2005 durchgeführt wurde, zu evaluieren und mit den früher publizierten Daten aus unserer Region, in der das Programm 1985 eingeführt wurde, zu vergleichen. PATIENTEN UND METHODEN: Von den 17846 in der 9-jährigen Beobachtungsperiode in unserer Frauenklinik geborenen Neugeborenen wurden 17393 in die Studie aufgenommen. Alle Hüften wurden mittels Ultraschall in der 1. Lebenswoche untersucht. Von 2,5% der Neugeborenen waren die Daten nicht verfügbar. Die Inzidenz der sonographisch erhobenen Hüfttypen nach der Methode von Graf wurde analysiert. Außerdem wurde die Geschlechtsverteilung bzw. die Seite der Hüftpathologie erhoben. ERGEBNISSE: 34786 Hüften wurden sonographisch untersucht. 84,9% waren bei der ersten Untersuchung reif (Graf Typ Ia und Ib), 14,1% wurden als unreif (Graf Typ IIa) klassifiziert und in 1,1% wurde ein pathologischer Befund (Graf Typ IIc oder schlechter) festgestellt. Mädchen wiesen häufiger (3,9:1) einen pathologischen Befund als Knaben. Die linke Hüfte war etwas häufiger betroffen als die rechte (1,2:1). Während des Beobachtungszeitraums nahm die Anzahl der erhobenen pathologischen Befunde (Graf Typ IIc oder schlechter) um das 7-Fache ab (von 2,1% in 1997 auf 0,3% in 2005). Diese Verteilung der Hüfttypen führte zu einer durchschnittlichen Behandlungsrate von 18 Neugeborenen auf 1000 Lebendgeborene im Jahr 1997 (von 42 behandelten Hüften auf 1000 im Jahr 1997 zu 6 Hüften auf 1000 im Jahr 2005). Im gesamten Beobachtungszeitraum benötigten nur 19 Patienten eine operative Therapie der Hüftdysplasie vor dem Alter von 3 Jahren. SCHLUSSFOLGERUNG: In unserer Region scheint ein allgemeines Neugeborenen-Screening auf EDH die Gesamt-Behandlungsrate wirksam zu senken. Die Zahl der operativen Korrekturen blieb während der Beobachtungs-periode von 9 Jahren stabil, war aber in dieser Zeit niedriger als in der Zeit vor Einführung der Ultraschalluntersuchung.

Summary

AIM: Ultrasound imaging has become an accepted tool for accurate diagnosis of developmental dysplasia of the hip (DDH) and for its management. The aim of the present study was to evaluate the results of the general neonatal hip screening program in Maribor between 1997 and 2005 in comparison with earlier reported results for our region, where this program was introduced in 1985. PATIENTS AND METHODS: Of the total number of 17,846 newborns born in our maternity hospital, 17,393 were included in the study during the nine-year period. All hips were examined by ultrasonography within the first week of life. Data for 2.5% of newborns were not available. The incidence of sonographic hip types according to the Graf method was analyzed, together with the sex distribution, lateralization of hip pathology and treatment recommendations. RESULTS: A total of 34,786 hips were evaluated sonographically: 84.9% of hips were mature at first examination (Graf types Ia and Ib), 14.1% were immature (Graf type IIa) and 1.1% were pathological (Graf types IIc or worse). In the group of pathological hips, girls were more frequently affected than boys (3.9:1) and the left hip was more frequently affected than the right (1.2:1). The incidence of hip types IIc or worse decreased sevenfold throughout the observation period, from 2.1 in 1997 to 0.3 in 2005. This distribution of hip types resulted in an average treatment rate of 18 newborns per 1000 live borns, down from 42 treated hips per 1000 newborns in 1997 to 6 hips per 1000 in 2005. During this nine-year period, only 19 children required surgical treatment for DDH before the age of three years. CONCLUSION: In our region, general ultrasound hip screening of newborns for DDH seems to be effective in reducing the overall treatment rate. The number of surgical procedures has remained stable during the past nine-year screening period and is lower than in the pre-ultrasound era.

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Authors and Affiliations

  1. Department of Perinatology, Unit of Neonatology, Maribor Teaching Hospital, Maribor, Slovenia

    Milena Treiber, Andreja Tekauc-Golob, Jože Žolger, Bojan Korpar & Silva Burja

  2. Department of Orthopedics, Maribor Teaching Hospital, Maribor, Slovenia

    Tomaž Tomažič

  3. Gynecology and Perinatology Services, Maribor Teaching Hospital, Maribor, Slovenia

    Iztok Takač

  4. Department of Perinatology, Maribor Teaching Hospital, Maribor, Slovenia

    Aleksander Sikošek

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  1. Milena Treiber
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  2. Tomaž Tomažič
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  3. Andreja Tekauc-Golob
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  4. Jože Žolger
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  5. Bojan Korpar
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  6. Silva Burja
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  7. Iztok Takač
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  8. Aleksander Sikošek
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Correspondence to Milena Treiber.

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Treiber, M., Tomažič, T., Tekauc-Golob, A. et al. Ultrasound screening for developmental dysplasia of the hip in the newborn: a population-based study in the Maribor region, 1997–2005. Wien Klin Wochenschr 120, 31–36 (2008). https://doi.org/10.1007/s00508-007-0922-0

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  • DOI: https://doi.org/10.1007/s00508-007-0922-0

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