The Influence of Risk Factors in the Early Detection of Developmental Dysplasia of the Hip in a Country with Limited Material Resources

Developmental dysplasia of the hip (DDH) is a condition that includes a wide spectrum of anomalies ranging from simple instability with ligamentous hyperlaxity to the complete displacement of the femoral head outside the abnormally developed cotyloid cavity. Early detection and initiation of treatment allow “restitutio ad integrum” healing, which has raised the medical community’s interest in early diagnosis. However, in countries with limited material resources, where echographic screening is not performed, efforts are being made to increase the sensitivity of clinical screening. Thus, the concept of “hip at risk” is taking shape worldwide. This is the normal clinical hip, but associated with one or more risk factors. We conducted a retrospective study for the period 2010–2015 with patients who presented in the ambulatory clinic of the St. John Children’s Clinical Hospital, Galati. The study included 560 patients, who were all examined clinically and sonographically, according to the Graf method, by a senior orthopedic doctor with competence in hip sonography. The data obtained from the anamnesis, clinical examination, and ultrasound examination were recorded in the DDH file. The goal of the statistical analysis of the group of patients was to find a correlation between DDH and the risk factors used in the clinical detection of this pathology. In the studied group, four risk factors were identified that have an increased association with DDH: female sex, pelvic presentation, limitation of coxo-femoral abduction, and congenital clubfoot; thus, the conclusion of the study is that patients who have at least one of the listed risk factors should be examined sonographically as quickly as possible. The early ultrasound examination will allow the identification of the disease and the initiation of treatment.

[1]  T. Abualait,et al.  Developmental dysplasia of the hip and associated risk factors in Saudi children: A retrospective study. , 2021, Journal of back and musculoskeletal rehabilitation.

[2]  A. Roposch,et al.  Predicting developmental dysplasia of the hip in at-risk newborns , 2020, BMC Musculoskeletal Disorders.

[3]  L. Danišovič,et al.  Developmental Dysplasia of the Hip: A Review of Etiopathogenesis, Risk Factors, and Genetic Aspects , 2020, Medicina.

[4]  D. Dolinar,et al.  Secondary hip dysplasia increases risk for early coxarthritis after Legg-Calve-Perthes disease. A study of 255 hips , 2019, Computer methods in biomechanics and biomedical engineering.

[5]  G. Gökçay,et al.  Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population , 2019, BioMed research international.

[6]  J. Dieleman,et al.  Developmental dysplasia of the hip in children with Down syndrome: comparison of clinical and radiological examinations in a local cohort , 2019, European Journal of Pediatrics.

[7]  H. Prior,et al.  Relative Risk and Incidence for Developmental Dysplasia of the Hip , 2017, The Journal of pediatrics.

[8]  P. Cox,et al.  Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors , 2016, Journal of children's orthopaedics.

[9]  Y. Byun,et al.  Unusual Cause of Hip Pain: Intrusion of the Acetabular Labrum , 2015, Hip & pelvis.

[10]  L. Engesæter,et al.  Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991–2006 , 2014, Pediatric Radiology.

[11]  F. Grill,et al.  Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip: the Austrian hip screening program , 2014, Journal of children's orthopaedics.

[12]  Mark A. Levenstien,et al.  Developmental Dysplasia of the Hip: Linkage Mapping and Whole Exome Sequencing Identify a Shared Variant in CX3CR1 in All Affected Members of a Large Multigeneration Family , 2013, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[13]  K. Rosendahl,et al.  Parent satisfaction with early and delayed abduction splinting therapy of developmental hip dysplasia , 2013, Acta paediatrica.

[14]  Pooja Gulati,et al.  Developmental dysplasia of the hip in the newborn: A systematic review. , 2013, World journal of orthopedics.

[15]  W. J. Hart,et al.  The association between mode of delivery and developmental dysplasia of the hip in breech infants: a systematic review of 9 cohort studies. , 2012, Acta orthopaedica Belgica.

[16]  P. Koşar,et al.  Developmental Dysplasia in Male Infants: Risk Factors, Instability and Ultrasound Screening , 2011, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[17]  H. Nawaz,et al.  Developmental dysplasia of the hip , 2010, Orthopedic reviews.

[18]  D. Viskochil,et al.  Familial Predisposition to Developmental Dysplasia of the Hip , 2009, Journal of pediatric orthopedics.

[19]  I. Dalen,et al.  Diagnosis of congenital hip dysplasia in the newborn , 2008, Acta orthopaedica.

[20]  Clinical Practice Guideline: Early Detection of Developmental Dysplasia of the Hip , 2000, Pediatrics.

[21]  S. C. Huang,et al.  Treatment of developmental dysplasia of the hip after failed open reduction. , 1998, Journal of the Formosan Medical Association = Taiwan yi zhi.

[22]  E. Haan,et al.  Perinatal risk factors for developmental dysplasia of the hip , 1997, Archives of disease in childhood. Fetal and neonatal edition.

[23]  R. Castelein,et al.  Ultrasound Screening for Congenital Dysplasia of the Hip in Newborns: Its Value , 1988, Journal of pediatric orthopedics.

[24]  G. Tusnády,et al.  Two family studies on congenital dislocation of the hip after early orthopaedic screening Hungary. , 1975, Journal of medical genetics.

[25]  D. Rabin,et al.  UNTREATED CONGENITAL HIP DISEASE. A STUDY OF THE EPIDEMIOLOGY, NATURAL HISTORY, AND SOCIAL ASPECTS OF THE DISEASE IN A NAVAJO POPULATION. , 1965, American journal of public health and the nation's health.

[26]  P. Dunn Perinatal observations on the etiology of congenital dislocation of the hip. , 1976, Clinical orthopaedics and related research.