Results of a universal ultrasonographic hip screening program at a single institution

Abstract

Objective: The aims of the present study were to determine the prevalence of developmental dysplasia of the hip (DDH) in newborns screened by hip ultrasonography (US), to review outcome of followup and treatment of infants with DDH, and to evaluate the relationship between US-based diagnosis and risk factors.
Methods: A total of 9564 hips of 4782 newborns (2398 females, 50.1%) were evaluated with US. Risk factors for DDH and accompanying deformities were also recorded. Graf classification type IIa(-), IIb, IIc, D, and III hips were treated with Pavlik harnesses.
Results: Abnormal US findings (type IIa, IIc, or D hips) were detected in 475 newborns (9.9%). Risk factors and concomitant orthopedic deformities were similar in newborns with and without US abnormality and type I hips (p>0.05 for all). However, abnormal US findings were significantly more common in firstborn and female newborns. A total of 39 hips (5 bilateral, 20 left, 9 right) of 34 newborns
(31 females) were placed in Pavlik harnesses. Twelve newborns had type IIc or D hips at initial evaluation, and 22 had type IIb or IIa(-) at follow-up. Mean recovery time was 12.5 (8–16) weeks for newborns with type IIc and D hips, 8.6 (8–12) weeks for those with type IIa(-) hips, and 11.2 (8–12) weeks for those with type IIb hips.
Conclusion: DDH is still common among newborns in Turkey. Hip US is recommended for detection and follow-up of DDH in newborns.

Keywords

• Developmental dysplasia of the hip; ultrasonography; Pavlik harness; risk factors.