Assessment of Variations in the Measurement of Hip Ultrasonography by the Graf Method in Developmental Dysplasia of the Hip§

2001 ◽  
Vol 10 (2) ◽  
pp. 89-95 ◽  
Author(s):  
Hakan Ömeroğlu ◽  
Ali Biçmoǧlu ◽  
Süha Koparal ◽  
Sinan Seber
Keyword(s):  
Developmental Dysplasia ◽  
Graf Method ◽  
Dysplasia Of The Hip ◽  
Hip Ultrasonography

scholarly journals Early detection of developmental dysplasia of hip by ultrasound

2019 ◽  
pp. 112070001987968 ◽  
Author(s):  
Zita Gyurkovits ◽  
Gellért Sohár ◽  
Anna Baricsa ◽  
Gábor Németh ◽  
Hajnalka Orvos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Positive Family History ◽  
Breech Presentation ◽  
Female Gender ◽  
Developmental Dysplasia ◽  
Developmental Dysplasia Of Hip ◽  
Graf Method ◽  
Hip Ultrasound ◽  
A Prospective Study ◽  
Dysplasia Of The Hip

Objective: To assess the effectiveness of early universal ultrasound (US) screening of developmental dysplasia of the hip (DDH). Study design: A prospective study of universal hip screening of all mature neonates was conducted from 2012 to 2013, at the Department of Obstetrics and Gynaecology, University of Szeged; 1636 newborns (3272 hips) had clinical examinations and hip ultrasound by the Graf method within the1st 3 days of life. Prevalence of DDH, risk factors, sensitivity and specificity of clinical examinations were evaluated. Results: At the 1st US, 70 of the examined 3272 hips (2.14%) were found to be positive. According to Graf categories, the following distribution was observed: type II C, 21 hips (30.0%); D, 24 hips (34.28%); III, 24 hips (34.28%); IV, 1 hip (1.44%). Regarding the risk factors, female gender, breech presentation and positive family history proved to be significant. Interestingly, 28 (50.90%) of the 55 newborns with DDH had neither positive physical signs nor any risk factors, except being female. The physical examination was calculated for sensitivity (20.0%) and specificity (98.34%). Conclusions: In our 1-year period study, 50.9% of the newborns with DDH had neither any positive physical signs nor any risk factors, except being a female. In contrast, early universal US screening of the hip facilitated to diagnose all cases with hip dysplasia. Hip sonography is an effective mode of prevention in orthopaedics, however further studies are needed to compare the rates of operative procedures in selective versus universal screening models.

scholarly journals The predictive value of the clinical sign of excessive hip abduction for developmental dysplasia of the hip (DDH)

2018 ◽  
Vol 48 (1-2) ◽  
Author(s):  
Svemir Čustović ◽  
Kenan Čustović
Keyword(s):  
Clinical Sign ◽  
Predictive Value ◽  
Ultrasound Examination ◽  
Developmental Dysplasia ◽  
Gynecology And Obstetrics ◽  
Hip Abduction ◽  
Graf Method ◽  
The University ◽  
The Relationship ◽  
Dysplasia Of The Hip

Aim To assess the relationship between the clinical sign of excessive hip abduction (abduction of the hip 90 degrees or more) and developmental dysplasia of the hip (DDH). Methods The research was conducted on 450 newborns in the Neonatal Unit at the Clinic of Gynecology and Obstetrics and the Clinic of Orthopedics and Traumatology of the University Clinical Centre, Tuzla, between 30th August 2011 and 30th April 2012. Clinical (degree of hip abduction) and ultrasound examination of all newborns hip were performed using the Graf method on their first day of life. Results Clinical sign of excessive hip abduction showed significant predictive value for DDH. There were 37 (8.2%) newborns with the clinical sign of excessive hip abduction, of which 13 of them had DDH while 24 of them did not have this clinical sign. There were 89 newborns, in the overall sample, with one of the forms of DDH, 13 (12.7%) of them had this clinical sign, while from 324 newborns witouth DDH, 24 (6.9%) had this clinical sign. Excessive hip abduction had a positive predictive value (PPV) of 35.1% and a negative predictive value (NPV) of 78.5% for DDH. Conclusion Excessive hip abduction is an useful and important clinical sign of DDH. Doctors who perform the first examination of the child after birth, would have to turn their attention to this clinical sign. The newborns with this clinical sign would have to go to an ultrasound examination of the hips for further diagnosis.

Results of universal ultrasound screening for developmental dysplasia of the hip

2018 ◽  
Vol 100-B (10) ◽  
pp. 1399-1404 ◽  
Author(s):  
R. Biedermann ◽  
J. Riccabona ◽  
J. M. Giesinger ◽  
A. Brunner ◽  
M. Liebensteiner ◽  
...  
Keyword(s):  
Open Reduction ◽  
Open Surgery ◽  
Developmental Dysplasia ◽  
Consecutive Series ◽  
Type I ◽  
Ultrasound Screening ◽  
Treatment Rate ◽  
Cumulative Rate ◽  
Graf Method ◽  
Dysplasia Of The Hip

Aims The purpose of this study was to analyze the incidence of the different ultrasound phenotypes of developmental dysplasia of the hip (DDH), and to determine their subsequent course. Patients and Methods A consecutive series of 28 092 neonates was screened and classified according to the Graf method as part of a nationwide surveillance programme, and then followed prospectively. Abnormal hips were followed until they became normal (Graf type I). Type IIb hips and higher grades were treated by abduction in a Tübinger orthosis until normal. Dislocated hips underwent closed or open reduction. Results Overall, 90.2% of hips were normal at birth. Type IIa hips (8.9%) became normal at a median of six weeks (interquartile range (IQR) 6 to 9). Type IIc and IId hips (0.67%) became normal after ten weeks (IQR 7 to 13). There were 19 type lll and eight type lV hips at baseline. There were 24 closed reductions and one open reduction. No late presentations of DDH were detected within the first five years of life. Conclusion The incidence of DDH was eight per 1000 live births. The treatment rate was 1% (n = 273). The rate of first operations on the newborn hip was 0.86, and rate of open surgery was 0.04. The cumulative rate of open surgery was 0.07. The authors take the view that early identification and treatment in abduction of all dysplastic hips in early childhood reduces the rate of open reduction and secondary DDH-related surgery later in life. Cite this article: Bone Joint J 2018;100-B:1399–1404.

scholarly journals Open reduction for developmental dysplasia of the hip: failures of screening or failures of treatment?

2013 ◽  
Vol 95 (2) ◽  
pp. 113-117 ◽  
Author(s):  
AP Sanghrajka ◽  
CF Murnaghan ◽  
A Shekkeris ◽  
DM Eastwood
Keyword(s):  
Open Reduction ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Early Management ◽  
Street Hospital ◽  
Great Ormond Street Hospital ◽  
Maternity Hospitals ◽  
Neonatal Hip ◽  
Dysplasia Of The Hip ◽  
Hip Ultrasonography

Introduction The aim of this study was to define the clinical indications and demographic characteristics of patients undergoing open reduction for developmental dysplasia of the hip (DDH), and determine the proportion due to preventable failures of contemporary clinical screening and early management. Methods Case notes were reviewed of consecutive primary open reductions performed for non-teratologic hip dislocation at the Great Ormond Street Hospital for Children over a five-year period. Forty-eight patients (64 hips) were suitable for inclusion. A telephone survey confirmed selective hip ultrasonography screening protocols were employed in all maternity hospitals in our referral base. Results There were no cases of open reduction for unilateral DDH following Pavlik treatment commenced by six weeks of age, highlighting the importance of early detection and treatment. Eleven cases (23%) may have been avoided by appropriate implementation of existing selective ultrasonography screening protocols. Thirty-four cases (71%) presented after four months of age, suggesting open reduction is associated with late diagnosis rather than failure of primary management. None of these patients had neonatal hip ultrasonography and only 12% (4 patients) had a risk factor that should have triggered a scan. Conclusions Compared with published results, the contemporary screening practices in our referral base are failing to eliminate late presenting DDH and the need for open surgical reduction. Changes in strategy and implementation are required to significantly improve screening efficacy.

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