What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

Abstract

Developmental dysplasia of the hip (DDH) is an important cause of childhood disability. Subluxation or dislocation can be diagnosed through pediatric physical examination; nevertheless, the ultrasonographic examination is necessary in diagnosing certain borderline cases. It has been evaluated routine sonographic examination of 2,444 hips of 1,222 babies to determine differences in both, developmental dysplasia and types of hips, and evaluated their development on the 3-month follow-up. Evaluating the pathologic “α” angles under 59, there was no statistically significant differences between girls and boys in both right (55.57 ± 3.73) (56.20 ± 4.01), (p = 0.480), and left (55.79 ± 3.96) (57.00 ± 3.84), (p = 0.160) hips on the 45th day of life. Routine sonographic examinations on the 45th day of life revealed that 51 of (66.2%) 77 type 2a right hips were girls and 26 (33.8%) were boys. The number of the right hips that develop into type 1 was 38 (74.5%) for girls and 26 (100%) for boys on the 90th day of life (p = 0.005). A total of 87 type 2a left hips included 64 girls (73.6%) and 23 boys (26.4%). In the 90th day control, 49 right hip of girls (76.6%) and 21 right hip of boys (91.3%) developed into type 1 (p = 0.126). In the assessment of both left and right hips, girls showed a significantly higher frequency in latency and boys showed significantly higher development in the control sonography. A total of 31 girls (2.5%) and 11 boys (0.9%) accounted for a total of 42 (3.4%) cases who showed bilateral type 2a hips in 1,222 infants. On the 90th day control, 26 girls (83.9%) and all 11 boys (100%) developed into type 1 (p = 0.156). The study emphasizes the importance of the sonographic examination on the 90th day of life. Results of the investigation include the data of sonographic screening of DDH on the 45th day, and also stress the importance of the 90th-day control sonography after a close follow-up with physical examination between 45th and 90th days of life.

Keywords

developmental dysplasia of the hip - sonography - follow-up examination

• References

• 1 Kolb A, Schweiger N, Mailath-Pokorny M. , et al. Low incidence of early developmental dysplasia of the hip in universal ultrasonographic screening of newborns: analysis and evaluation of risk factors. Int Orthop 2016; 40 (01) 123-127
• 2 Dorn U, Neumann D. Ultrasound for screening developmental dysplasia of the hip: a European perspective. Curr Opin Pediatr 2005; 17 (01) 30-33
• 3 Dogruel H, Atalar H, Yavuz OY, Sayli U. Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip. Int Orthop 2008; 32 (03) 415-419
• 4 Lehmann HP, Hinton R, Morello P, Santoli J. Developmental dysplasia of the hip practice guideline: technical report. Committee on Quality Improvement, and Subcommittee on Developmental Dysplasia of the Hip. Pediatrics 2000; 105 (04) E57
• 5 Graf R. New possibilities for the diagnosis of congenital hip joint dislocation by ultrasonography. J Pediatr Orthop 1983; 3 (03) 354-359
• 6 Graf R, Aksu M, Farkas P, Lercher K, Tschauner C. Kalça ultrasonografisi el kitabı. Istanbul, Turkey: AVRUPA Tip Kitapçilik Ltd.; 2011: 14-20
• 7 Graf R. Ultrasonography-guided therapy [in German]. Orthopade 1997; 26 (01) 33-42
• 8 Donma MM, Donma O, Sonmez S. Prediction of birth weight by ultrasound in Turkish population. Which formula should be used in Turkey to estimate fetal weight?. Ultrasound Med Biol 2005; 31 (12) 1577-1581
• 9 Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet 2007; 369 (9572): 1541-1552
• 10 Ortiz-Neira CL, Paolucci EO, Donnon T. A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol 2012; 81 (03) e344-e351
• 11 Bache CE, Clegg J, Herron M. Risk factors for developmental dysplasia of the hip: ultrasonographic findings in the neonatal period. J Pediatr Orthop B 2002; 11 (03) 212-218
• 12 Laborie LB, Markestad TJ, Davidsen H. , et al. Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991-2006. Pediatr Radiol 2014; 44 (04) 410-424
• 13 Shipman SA, Helfand M, Moyer VA, Yawn BP. Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventive Services Task Force. Pediatrics 2006; 117 (03) e557-e576
• 14 Sewell MD, Eastwood DM. Screening and treatment in developmental dysplasia of the hip-where do we go from here?. Int Orthop 2011; 35 (09) 1359-1367
• 15 Sibiński M, Adamczyk E, Higgs ZC, Synder M. Hip joint development in children with type IIb developmental dysplasia. Int Orthop 2012; 36 (06) 1243-1246
• 16 Agus H, Bozoglan M, Kalenderer Ö, Kazımoğlu C, Onvural B, Akan İ. How are outcomes affected by performing a one-stage combined procedure simultaneously in bilateral developmental hip dysplasia?. Int Orthop 2014; 38 (06) 1219-1224
• 17 Loder RT, Shafer C. The demographics of developmental hip dysplasia in the Midwestern United States (Indiana). J Child Orthop 2015; 9 (01) 93-98
• 18 Orak MM, Karaman O, Gursoy T, Cagirmaz T, Oltulu I, Muratli HH. Effect of increase in birth weight in a newborn on hip ultrasonography. J Pediatr Orthop B 2015; 24 (06) 507-510