Subscribe to RSS
Proﬁle of Patients Diagnosed with Developmental Dysplasia of the Hip[*]Article in several languages: português | English
20 December 2017
21 February 2018
09 October 2019 (online)
Objective To describe the proﬁle of patients with developmental dysplasia of the hip (DDH) diagnosed by physical and ultrasound examination, with the implementation of a protocol for the treatment and follow-up of DDH.
Methods A cross-sectional study with DDH patients born between January 2014 and December 2016, in the city of Pelotas, Southern Brazil. Ethnicity, gender, birth weight, fetal presentation, affected side of the hip, gestational age, maternal age and family history were considered. The data on the medical records were compared with the characteristics of the general population described on the Brazilian National Information System on Live Births (Sistema de Informação sobre Nascidos Vivos [SINASC]).
Results A total of 33 DDH patients were identiﬁed, mostly female, with a four-fold higher probability of having the condition (p < 0.001); the left was the most affected side. No statistically signiﬁcant association was found regarding the following factors: birth weight, gestational age, ethnicity, and maternal age. The newborns in breech presentation had a 15-fold higher probability of presenting DDH (p < 0.001). A total of 21 newborns required immediate treatment of the hips, since the ultrasound showed a Graf classiﬁcation of IIb or higher, or the radiography showed dislocation in DDH patients older than 6 months of age.
Conclusion Screening for DDH is essential in all newborns; physical examinations revealing alterations must be complemented with ultrasound imaging to avoid the delayed diagnosis of the condition.
* Work developed at Master in Child and adolescent health of Universidade Católica de Pelotas. RS, Brazil. Originally Published by Elsevier.
- 1 Guarniero R. Displasia do desenvolvimento do quadril: atualização. Rev Bras Ortop 2010; 45 (02) 1-9
- 2 Omeroğlu H. Use of ultrasonography in developmental dysplasia of the hip. J Child Orthop 2014; 8 (02) 105-113
- 3 Schams M, Labruyère R, Zuse A, Walensi M. Diagnosing developmental dysplasia of the hip using the Graf ultrasound method: risk and protective factor analysis in 11,820 universally screened newborns. Eur J Pediatr 2017; 176 (09) 1193-1200
- 4 Ishida A, Kuwajima SS. Propedêutica ortopédica do quadril pediátrico. In: Leite NM, Faloppa F. , eds. Propedêutica ortopédica e traumatológica. Porto Alegre: Artes Médicas; 2013: 381-5
- 5 Woodacre T, Dhadwal A, Ball T, Edwards C, Cox PJ. The costs of late detection of developmental dysplasia of the hip. J Child Orthop 2014; 8 (04) 325-332
- 6 Mahan ST, Katz JN, Kim YJ. To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg Am 2009; 91 (07) 1705-1719
- 7 Moraleda L, Albiñana J, Salcedo M, Gonzalez-Moran G. [Dysplasia in the development of the hip]. Rev Esp Cir Ortop Traumatol 2013; 57 (01) 67-77
- 8 Chan A, McCaul KA, Cundy PJ, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 1997; 76 (02) F94-F100
- 9 Mulpuri K, Schaeffer EK, Andrade J. , et al; IHDI Study Group. What risk factors and characteristics are associated with late-presenting dislocations of the hip in infants?. Clin Orthop Relat Res 2016; 474 (05) 1131-1137
- 10 Loder RT, Shafer C. The demographics of developmental hip dysplasia in the Midwestern United States (Indiana). J Child Orthop 2015; 9 (01) 93-98
- 11 Thaler M, Biedermann R, Lair J, Krismer M, Landauer F. Cost-effectiveness of universal ultrasound screening compared with clinical examination alone in the diagnosis and treatment of neonatal hip dysplasia in Austria. J Bone Joint Surg Br 2011; 93 (08) 1126-1130
- 12 Wynne-Davies R. Acetabular dysplasia and familial joint laxity: two etiological factors in congenital dislocation of the hip. A review of 589 patients and their families. J Bone Joint Surg Br 1970; 52 (04) 704-716
- 13 Mace J, Paton RW. Neonatal clinical screening of the hip in the diagnosis of developmental dysplasia of the hip: a 15-year prospective longitudinal observational study. Bone Joint J 2015; 97-B (02) 265-269
- 14 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
- 15 Karol LA. Developmental dysplasia of the hip. In: Song KM. Orthopaedics Knowledge Update: Pediatrics 4. Rosemont, IL: American Academy of Orthopaedics Surgeons; 2011: 159-68
- 16 Orak MM, Onay T, Gümüştaş SA, Gürsoy T, Muratlí HH. Is prematurity a risk factor for developmental dysplasia of the hip?: a prospective study. Bone Joint J 2015; 97-B (05) 716-720
- 17 Woodacre T, Ball T, Cox P. Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors. J Child Orthop 2016; 10 (06) 633-642
- 18 Paton RW, Hinduja K, Thomas CD. The significance of at-risk factors in ultrasound surveillance of developmental dysplasia of the hip. A ten-year prospective study. J Bone Joint Surg Br 2005; 87 (09) 1264-1266
- 19 Williams D, Protopapa E, Stohr K, Hunter JB, Roposch A. The most relevant diagnostic criteria for developmental dysplasia of the hip: a study of British specialists. BMC Musculoskelet Disord 2016; 17: 38
- 20 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
- 21 Benson MKD, Macnicol MF. Developmental dysplasia of the hip. In: Benson M, Fixsen J, Macnicol M, Parsch K. , eds. Children's orthopaedics and fractures. 3rd ed. London: Churchill-Livingstone; 2010: 359-82
- 22 Donnelly KJ, Chan KW, Cosgrove AP. Delayed diagnosis of developmental dysplasia of the hip in Northern Ireland: can we do better?. Bone Joint J 2015; 97-B (11) 1572-1576
- 23 Thomas SR. A review of long-term outcomes for late presenting developmental hip dysplasia. Bone Joint J 2015; 97-B (06) 729-733
- 24 Ortolani M. Um segno poco noto c sua importanza per la diagnosi prococe de prelussazione congenita dell'anca. Pediatria (Napoli) 1937; 45: 129-136
- 25 Von Rosen S. ; von ROSEN. Diagnosis and treatment of congenital dislocation of the hip hoint in the new-born. J Bone Joint Surg Br 1962; 44-B (02) 284-291
- 26 Schwend RM, Schoenecker P, Richards BS, Flynn JM, Vitale M. ; Pediatric Orthopaedic Society of North America. Screening the newborn for developmental dysplasia of the hip: now what do we do?. J Pediatr Orthop 2007; 27 (06) 607-610
- 27 Arti H, Mehdinasab SA, Arti S. Comparing results of clinical versus ultrasonographic examination in developmental dysplasia of hip. J Res Med Sci 2013; 18 (12) 1051-1055
- 28 Finne PH, Dalen I, Ikonomou N, Ulimoen G, Hansen TW. Diagnosis of congenital hip dysplasia in the newborn. Acta Orthop 2008; 79 (03) 313-320
- 29 Problemas Ortopédicos. In: Atenção à Saúde do Recém-Nascido: Guia para Profissionais de Saúde. Brasília: Ministério da Saúde; 2012