Screening of Developmental Dysplasia of the Hip in Neonates with Breech Presentation

2015 ◽  
Vol 18 (10.2015) ◽  
pp. 0-0
Keyword(s):  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

scholarly journals Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Kural ◽  
Esra Devecioğlu Karapınar ◽  
Pınar Yılmazbaş ◽  
Tijen Eren ◽  
Gülbin Gökçay
Keyword(s):  
Risk Factors ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Female Sex ◽  
Dysplasia Of The Hip

Aim. Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods. In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results. A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. Conclusion. According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

scholarly journals Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study

2019 ◽  
Vol 13 (2) ◽  
pp. 161-166 ◽  
Author(s):  
H. Ömeroğlu ◽  
A. Akceylan ◽  
N. Köse
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Hip Dysplasia ◽  
Positive Family History ◽  
Significant Risk ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Dysplasia Of The Hip

Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened. Level of Evidence Level III prognostic study

scholarly journals Association between timing and duration of breech presentation during pregnancy and developmental dysplasia of the hip: A case-control study

2021 ◽  
pp. 136749352110421
Author(s):  
Annemieke Konijnendijk ◽  
Ellen Vrugteveen ◽  
Brenda Voorthuis ◽  
Magda Boere-Boonekamp
Keyword(s):  
Case Control Study ◽  
Breech Presentation ◽  
Case Control ◽  
Developmental Dysplasia ◽  
Self Report ◽  
Online Questionnaire ◽  
Gestational Period ◽  
Gestational Week ◽  
Dysplasia Of The Hip ◽  
Control Study

This case-control study investigated the association between timing and duration of breech presentation in pregnancy and developmental dysplasia of the hip (DDH). Children with DDH aged 3 years or younger ( n = 191) were compared with healthy controls ( n = 209). Data on outcome, exposure and, covariates were collected using a parents’ self-report online questionnaire. Term children with breech presentation at one or more check-ups after 30.0 weeks gestation had a twofold higher risk of developing DDH compared to children who had never presented in breech (OR 2.01; 95% CI [1.28, 3.15]). The strength of the association increased with duration of breech presentation (5–8 weeks: OR 2.65; 95% CI [1.36, 5.18]; 9–12 weeks: OR 3.63; 95% CI [1.82, 7.24]). Children who had presented in breech at least once in gestational period 37.0-birth had a 3.24 (95% CI [1.86, 5.65]) times higher risk of DDH, whereas the risk for children with breech presentation in gestational period 30.0–36.6 only was not increased. Also after adjusting for confounders, children who had presented in breech after gestational week 37.0-birth had a more than threefold higher risk of DDH (OR 3.33; 95% CI [1.81, 6.13]) compared to children who were never in breech or in gestational period 30.0–36.6 only.

To study the cost-effectiveness of clinical screening with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns

2021 ◽  
Vol 8 (2) ◽  
pp. 71-74
Author(s):  
Dr. Pandurang M. Daule ◽  
Dr. Ganesh G. Zarekar ◽  
Dr. Sunil Natha Mhaske ◽  
Dr. Shreya N. Bhate
Keyword(s):  
Cost Effectiveness ◽  
Large Population ◽  
Breech Presentation ◽  
Population Based ◽  
Developmental Dysplasia ◽  
Type Iiib ◽  
Hip Replacements ◽  
Hip Reduction ◽  
The Cost ◽  
Dysplasia Of The Hip

Aim: To study the cost-effectiveness of clinical screen with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns. Methods: Retrospective study (2018-20). Term new borns had (i) target scan at 6 weeks—family history of DDH or breech presentation—and (ii) early scan—abnormal clinical screen. Results: In all, 58 babies had USG scan. Five early scans (Graf’s classification; three Type IIA, one Type IIC and one Type IIIB] and 15 target scans (Type IIA) were reported abnormal. All Type IIA DDH had subsequent 12 weeks' scans normal. Babies with Type IIIB and IIC had hip reduction surgery at 6 and 16 months of age, respectively. At cost 200 INR/scan, total 147?200 INR was incurred against two possible hip replacements prevented. Conclusion: Universal clinical screen with USG of hip can aid in early diagnosis of DDH in newborns. Large population-based studies from developing countries need to look in its cost-effectiveness.

scholarly journals There is No Link Between Birth Weight and Developmental Dysplasia of the Hip

2021 ◽  
Author(s):  
Charlotte Hanratty ◽  
Balamurugan Thyagarajan ◽  
Nicholas M. Clarke ◽  
Alexander Aarvold
Keyword(s):  
Birth Weight ◽  
Incomplete Data ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Future Research ◽  
High Birth Weight ◽  
Data Sets ◽  
Singleton Pregnancy ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Aims Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH. Patients and Methods This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS. Results There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, p = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent T test, p = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g (p < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH (p = 0.068), nor between males with and without DDH (p = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed (p = 0.543), nor according to breech presentation (p = 0.8). Longer gestation babies weighed more (p < 0.00001), yet showed no increase in DDH incidence (p = 0.64). Conclusion This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.

scholarly journals Role of arthrography in assessing the closed reduction in treatment of DDH.

2019 ◽  
Vol 26 (12) ◽  
pp. 2184-2187
Author(s):  
Khawar Shahzad ◽  
Rana Dawood Ahmad Khan ◽  
Sajjad Iqbal ◽  
Mazhar Mehmood ◽  
Beenish Israr ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Positive Family History ◽  
Breech Presentation ◽  
Ligamentum Teres ◽  
Developmental Dysplasia ◽  
Musculoskeletal Problems ◽  
Study Setting ◽  
Dysplasia Of The Hip ◽  
Normal Head

Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal problems in newborns. It occurs in 1in 1000 live births affecting girls more than boys and more associated with breech presentation and positive family history. Objectives: To evaluate the effectiveness of arthrography in assessing the closed reduction of DDH. Study Design: Clinicial Study. Setting: This study was conducted at Allied Hospital, Faisalabad, Pakistan, Period: From December 2013 to January 2016 and comprised patients of either gender. Material & Methods: DDH was diagnosed with help of clinical examination and radiological investigations. Arthrography was performed and images were taken in different positions of the hip which were evaluated and findings noted. Results: Out of 50 hips, 34 had normal looking head of femur while 16 patients had head of femur which was either smaller than normal or of abnormal shape. Shape of acetabulum was found normal in 41 hips. Normal labrum was present in 44, inverted in 4 and everted in 2 patients. Ligamentum teres was found hypertrophic in 6 patients. Normal head coverage was present in 40 while in 10 hips head of femur was lateralized ≥ 4 mm. No external obstruction to reduction was encountered. In 44 cases reduction was concentric and eccentric reduction was noted in 6 patients. Conclusion: Arthrography is of special help in assessing the reduction of hip in DDH as it provides information about shape of head of femur, shape of acetabulum, labrum, ligamentum teres, containment of the hip, coverage of head and external obstacles to reduction.

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 Breech Presentation in Twins as a Risk Factor for Developmental Dysplasia of the Hip

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eun Ji Oh ◽  
Jae Jung Min ◽  
Soon-Sun Kwon ◽  
Seong Been Kim ◽  
Chang Won Choi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Developmental dysplasia of the hip and associated risk factors in Saudi children: A retrospective study

2021 ◽  
pp. 1-8
Author(s):  
Alaa I. Ibrahim ◽  
Eman M. Mortada ◽  
Saeed Abdullah Alqahtani ◽  
Haya Alkathri ◽  
Rania Alsayyed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Positive Family History ◽  
Hip Dislocation ◽  
Breech Presentation ◽  
Female Gender ◽  
Developmental Dysplasia ◽  
P Values ◽  
Dysplasia Of The Hip ◽  
Associated Abnormalities

BACKGROUND: Studies investigating the association between developmental dysplasia of the hip (DDH) and risk factors in Saudi Arabia are rare. OBJECTIVE: Investigate the association between DDH and several risk factors among Saudi children. METHODS: The medical records of 82 children born in or admitted to King Abdul Aziz Medical City in Riyadh, Saudi Arabia with clinical suspicion of hip dislocation (HD) were included. The association between DDH and the following risk factors was investigated: age < 3 y, female-gender, twinning, first-born child, C-section, breech presentation, prematurity, positive family history and presence of associated abnormalities. RESULTS: HD was confirmed in 73 (89%) children (Positive HD) and excluded in 9 (11%) children (Negative HD). Eleven (13.4%) children were excluded from the positive cases as it was confirmed that they have paralytic hip dislocation not DDH. DDH was confirmed in 62 children (75.6%). The Chi square test (χ2) and odds ratios (OR) revealed that the positive family history, female-gender, age < 3 years, and presence of associated abnormalities had significant associations with the presence of DDH with P values and OR equal 0.00 (16.4), 0.002 (3.1), 0.005 (2.6), and 0.04 (1.9) respectively. Breech presentation, twinning, first-born children, prematurity, and C-section were not associated with DDH with P values and OR equal 0.93 (1.1), 0.46 (0.4), 0.11 (0.4), 0.08 (0.3), and 0.002 (0.3) respectively. CONCLUSIONS: Positive family history, female-gender, age < 3 years, and presence of associated abnormalities had approximately 16, 3, 2.5, and 2 times increased risk for DDH.

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