scholarly journals First Description of Factors Influencing the Outcome of Developmental Dysplasia of the Hip in Children’s Medical Center

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Mehrzad Mehdizadeh ◽  
Nasir Babakhan Kondori ◽  
Afrooz Zandifar ◽  
Hooman Alizadeh
Keyword(s):  
Amniotic Fluid ◽  
Treatment Response ◽  
Birth Order ◽  
Negative Impact ◽  
Medical Center ◽  
Developmental Dysplasia ◽  
Amniotic Fluid Index ◽  
Limb Anomalies ◽  
Dysplasia Of The Hip ◽  
Type Of Delivery

Background: There are several factors may have an impact on the prognosis of developmental dysplasia of the hip (DDH). They may change the outcome and treatment if they are present in a patient. Objectives: The objective of this study is to determine the association of those factors with the outcome. Patients and Methods: The study was performed on 74 infants with DDH in Children’s Medical Centre. After obtaining informed consent and ethical approval, patients with DDH confirmed by ultrasound were included, and possible risk factors including severity of DDH based on the Graf criteria, follow-up length, age, gender, laterality, type of delivery, amniotic fluid index, fetal anomalies, birth order of children, and methods of treatment were collected and compared against treatment response. Results: There were 58 female and 19 male patients with a mean age of 6.54 weeks. Bilateral DDH was found in 31 females and nine males. The average alpha and beta angles were 53.19 ± 5.7 and 66.53 ± 6.6 degree, respectively. The severity of DDH had a significant association with treatment response (P = 0.003). Recovery was better in females than in males (P = 0.031). In addition, the first‐born infants had a better response (P = 0.001). A meaningful connection (P = 0.01) was noted between the amniotic fluid index as well as renal/limb anomalies and treatment response. Type of delivery (cesarean versus vaginal) or fetal presentation had no significant association with treatment response (P > 0.05). Conclusion: Factors with a negative impact on DDH outcomes include the severity of DDH, male gender, higher birth order, oligohydramnios, renal and limb anomalies.

Three cases of developmental dysplasia of the hip on partially mummified human remains (Roccapelago, Modena, 18th Century): a study of palaeopathological indicators through direct analysis and 3D virtual models

2016 ◽  
Vol 28 (3-4) ◽  
pp. 202-212 ◽  
Author(s):  
M. Traversari ◽  
F. Feletti ◽  
A. Vazzana ◽  
G. Gruppioni ◽  
M. A. Frelat
Keyword(s):  
Femoral Head ◽  
Birth Order ◽  
18Th Century ◽  
Human Remains ◽  
Direct Analysis ◽  
Developmental Dysplasia ◽  
Current Data ◽  
Acetabular Roof ◽  
Mechanical Factors ◽  
Dysplasia Of The Hip

Developmental dysplasia of the hip (DDH) is caused by a delay in the development of the acetabular cavity, leading to an anomaly in the angle of the acetabular roof. As a result, the femoral head and the acetabular cavity do not interact normally. The identification of three cases of DDH among the remains discovered in the most recent unit from the crypt at Roccapelago (Modena, Italy) enabled us to discuss the presence of DDH in this region during the 18th century. All three cases are bilateral and Dunn class I, two have been identified as male and one as female. These DDH cases are very likely mainly due to mechanical factors such as the breech position of the foetus, perhaps associated with birth order. But given their overall similarity, they may also have resulted from the practice of swaddling new-borns. In addition, current data from the Italian Ministry of Health suggests that the incidence of DDH has remained stable in this region from the 18th century to the present. The ongoing study of remains from earlier units should bring a better understanding of the particular prevalence of DDH at Roccapelago.

scholarly journals Prevalence and epidemiological description of clubfoot at King Saud Medical City, Riyadh, Saudi Arabia

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Jameel H. Fakeeha ◽  
Abdullah E. Alessa ◽  
Musaad S. Alkhaldi ◽  
Mohammed H. Alshathri ◽  
Abdulaziz N. Althunayyan
Keyword(s):  
Saudi Arabia ◽  
Medical Center ◽  
Developmental Dysplasia ◽  
Birth Prevalence ◽  
Future Studies ◽  
Factors Associated ◽  
Medical City ◽  
Major Medical Center ◽  
History Of ◽  
Dysplasia Of The Hip

Objectives: Clubfoot is a burden affecting 150,000 newborns worldwide every year. This study looked at the prevalence of clubfoot at King Saud Medical City (KSMC) and examined the risk factors associated with clubfoot in Saudi Arabia. Methods: Data were collected through the medical system (Medisys) and the database of the orthopedic department intern at KSMC to determine the prevalence of clubfoot using the births recorded from 2015 to 2019 and reviewing their medical files. The epidemiological description of Saudi clubfoot patients was attained by collecting a sample of 100 patients from the clubfoot clinic database. Results: A total of 18,515 births at KSMC from 2015 to 2019 were evaluated. It was found that 42 patients were affected by clubfoot resulting in a birth prevalence of 2.3/1000 (0.23%) among Saudis at KSMC. Out of 100 clubfoot patients, 93% had no maternal history of chronic disease, while 31% of the cases were a product of consanguineous marriages. About 15% of the patients had an associated developmental dysplasia of the hip. Conclusion: This study estimates the prevalence of clubfoot in one major medical center in Saudi Arabia to be 2.3/1000. The findings support the data reported in the literature that males are more affected by clubfoot than females, with twice the likelihood that males will be affected by clubfoot. This study will provide an initial look at clubfoot in Saudi Arabia, which can build a base for future studies.

scholarly journals Does the Summer Season Affect the Amniotic Fluid Volume during Pregnancy?

2021 ◽  
Vol 18 (18) ◽  
pp. 9483
Author(s):  
Ah-Young Choi ◽  
Jun-Yi Lee ◽  
In-Sook Sohn ◽  
Han-Sung Kwon ◽  
Yong-Soo Seo ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Medical Center ◽  
Admission Rate ◽  
Well Being ◽  
Summer Season ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume ◽  
Clinically Significant ◽  
Nicu Admission

Amniotic fluid is crucial for the well-being of the fetus. Recent studies suggest that dehydration in a pregnant woman leads to oligohydramnios. We assessed the variation in the amniotic fluid index (AFI) during the summer and non-summer seasons and evaluated neonatal outcomes. We retrospectively reviewed electrical medical records of pregnant women who visited the Konkuk University Medical Center for antenatal care, between July 2005 and July 2019. A total of 19,724 cases from 6438 singleton pregnant women were included after excluding unsuitable cases. All AFI values were classified as 2nd and 3rd trimester values. Additionally, borderline oligohydramnios (AFI, 5–8) and normal AFI (AFI, 8–24) were assessed according to the seasons. The average AFI between the summer and non-summer season was statistically different only in the 3rd trimester; but the results were not clinically significant. In the 3rd trimester, the summer season influenced the increased incidence of borderline oligohydramnios. The borderline oligohydramnios group showed an increased small-for-gestational-age (SGA) rate and NICU admission rate. In the summer season, the incidence of borderline oligohydramnios was seen to increase. This result would be significant for both physicians and pregnant women.

AN ULTRASOUND SURVEY ON THE PLACENTA AND AMNIOTIC CHARACTERISTICS IN THE SINGLE POSTTERM PREGNANCY

2011 ◽  
pp. 20-24
Author(s):  
Thi My Dung Ha ◽  
Ngoc Thanh Cao ◽  
Thi Song Huong Tran
Keyword(s):  
Amniotic Fluid ◽  
Ultrasound Images ◽  
Ultrasound Scanning ◽  
Amniotic Fluid Index ◽  
Postterm Pregnancy ◽  
Fluid Properties ◽  
Labor Transfer ◽  
The Relationship ◽  
Obstetric Department ◽  
Singleton Pregnancies

Objective: To characterize ultrasound images of placenta and amniotic fluid in cases of singleton pregnancies beyond term predictions, and also explore the relationship between placenta, amniotic fluid and labor transfer status, postpartum child status. Image properties of prenatal placenta and amniotic fluid are immediately examined with ultrasound in 267 cases of postterm pregnancy beyond prediction at Obstetric Department, Hue Central Hospital. Results: In postterm pregnancy, placenta thickness decreases gradually according to gestational age. Oligohydramnios is 30.3%. There is a correlation between amniotic fluid index and birth method with r = 0.41. Sensitivity is 89.15%. Specificity is 48.55%. There is also a correlation between amniotic fluid echogenicity and method of birth: r = 0.478. Sensitivity is 97.67%. Specificity is 42.75%. Amniotic fluid index and baby Clifford's syndrome are also relevant, with r=0.466. Sensitivity is 83.78%. Specificity is 78.26%. Conclusions: Ultrasound scanning of amniotic fluid properties should be noted in the case of postterm pregnancy.

scholarly journals Prediction of the requirement of open reduction for developmental dysplasia of the hip

2017 ◽  
Vol 46 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Nabil Alassaf
Keyword(s):  
Open Reduction ◽  
Area Under The Curve ◽  
Internal Validity ◽  
Developmental Dysplasia ◽  
Estimation Model ◽  
Cross Sectional ◽  
Noninvasive Treatment ◽  
Dysplasia Of The Hip ◽  
Logistic Regression Equation ◽  
Objective Tool

Objective Closed reduction (CR) is a noninvasive treatment for developmental dysplasia of the hip (DDH), and this treatment is confirmed intraoperatively. This study aimed to develop a preoperative estimation model of the probability of requiring open reduction (OR) for DDH. Methods The study design was cross-sectional by screening all patients younger than 2 years who had attempted CR between October 2012 and July 2016 by a single surgeon. Potential diagnostic determinants were sex, age, side, bilaterality, International Hip Dysplasia Institute (IHDI) grade, and acetabular index (AI). An intraoperative arthrogram was the reference standard. A logistic regression equation was built from a reduced model. Bootstrapping was performed for internal validity. Results A total of 164 hips in 104 patients who met the inclusion criteria were analysed. The prevalence of CR was 72.2%. Independent factors for OR were older age, higher IHDI grade, and lower AI. The probability of OR = 1/[1 + exp − (−2.753 + 0.112 × age (months) + 1.965 × IHDI grade III (0 or 1) + 3.515 × IHDI grade IV (0 or 1) − 0.058 × AI (degrees)]. The area under the curve was 0.79. Conclusion This equation is an objective tool that can be used to estimate the requirement for OR.

scholarly journals Accuracy of New Deep Learning Model-Based Segmentation and Key-Point Multi-Detection Method for Ultrasonographic Developmental Dysplasia of the Hip (DDH) Screening

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1174
Author(s):  
Si-Wook Lee ◽  
Hee-Uk Ye ◽  
Kyung-Jae Lee ◽  
Woo-Young Jang ◽  
Jong-Ha Lee ◽  
...  
Keyword(s):  
Deep Learning ◽  
Intraclass Correlation ◽  
Alpha Angle ◽  
Learning Model ◽  
Developmental Dysplasia ◽  
Human Observer ◽  
Intraobserver Variability ◽  
Cad System ◽  
Deep Learning Model ◽  
Dysplasia Of The Hip

Hip joint ultrasonographic (US) imaging is the golden standard for developmental dysplasia of the hip (DDH) screening. However, the effectiveness of this technique is subject to interoperator and intraobserver variability. Thus, a multi-detection deep learning artificial intelligence (AI)-based computer-aided diagnosis (CAD) system was developed and evaluated. The deep learning model used a two-stage training process to segment the four key anatomical structures and extract their respective key points. In addition, the check angle of the ilium body balancing level was set to evaluate the system’s cognitive ability. Hence, only images with visible key anatomical points and a check angle within ±5° were used in the analysis. Of the original 921 images, 320 (34.7%) were deemed appropriate for screening by both the system and human observer. Moderate agreement (80.9%) was seen in the check angles of the appropriate group (Cohen’s κ = 0.525). Similarly, there was excellent agreement in the intraclass correlation coefficient (ICC) value between the measurers of the alpha angle (ICC = 0.764) and a good agreement in beta angle (ICC = 0.743). The developed system performed similarly to experienced medical experts; thus, it could further aid the effectiveness and speed of DDH diagnosis.

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