Developmental Dysplasia in Male Infants: Risk Factors, Instability and Ultrasound Screening

Koşar, Pınar Nercis; Ergün, Elif; Yiğit, Hasan; Gökharman, Fatma Dilek; Koşar, Uğur

doi:10.5301/hip.2011.8577

Cited by 12 publications

(13 citation statements)

References 26 publications

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“…Three months is the cut off age we used in our study to diagnose the late presentation of DDH, similar to Woodacre et al, 11 although different criteria was used in the literature for definition of late presenting DDH. The incidence of late diagnosed DDH in this group of male patients was 3.75%, which was higher than that observed by Kosar et al 6 in males diagnosed before the age of 14 weeks. The mean age at presentation in this study was 4.98 months (range 3-18).…”

Section: Discussioncontrasting

confidence: 69%

“…Approximately 44.2% of children with developmental hip dysplasia, mainly subclinical acetabular dysplasia did not demonstrate any risk factors. Kosar et al 6 found 0.9% of infants without risk factors developed DDH. This may increase our awareness regarding the significance of screening programs with high prevalence of hip dysplasia.…”

Section: Discussionmentioning

confidence: 97%

“…Only few studies addressed the issue of late-presenting DDH in male children. Kosar et al 6 had studied this spectrum in male infants and showed no statistical significance presented between risk factors and DDH in male cases. Jordanians are an ethnically distinct and homogenous population that has not been studied before.…”

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confidence: 99%

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Late-presenting developmental dysplasia of the hip in Jordanian males

Samarah

Hadidi

Hamdan

et al. 2016

SMJ

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Objectives:To describe the pattern of developmental dysplasia of the hip (DDH) in late presenting Jordanian male patients and identify the risk factors and associated findings.Methods:This is a retrospective study of 1145 male patients who attended the Pediatric Orthopedic Clinic for a DDH check up. This study was carried out in the Orthopedic Section, Special Surgery Department, Faculty of Medicine, The University of Jordan, Amman, Jordan between March 2011 and October 2014. Data was collected from medical records, and x-ray measurements were evaluated.Results:Of the 1145 male patients, 43 (3.75%) with 70 involved hips were diagnosed with late- presenting DDH. Being a first-born baby resulted in 41.9% increased risk for DDH. Cesarian delivery was significantly associated with an increased risk of hip dislocation (p=0.004) while normal delivery was significantly associated with acetabular dysplasia (p=0.004). No predictable risk factors were found in 44.2% patients with DDH. Bilateral cases were more common than unilateral cases: (26 [60.5%] versus 17 [39.5%]). Limited abduction was a constant finding in all dislocated hips (p<0.001). Associated conditions, such as club foot and congenital muscular torticollis were not observed.Conclusion:Cesarian section is a significant risk for dislocated hips while normal delivery is significantly associated with acetabular dysplasia. Bilateral DDH is more common than the unilateral. Club foot and torticollis were not observed in this series.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 97%

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Late-presenting developmental dysplasia of the hip in Jordanian males

Samarah

Hadidi

Hamdan

et al. 2016

SMJ

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“… 19 – 23 Between 0 and three months 93% of 1578 Graf IIa hips developed to Graf I hips without treatment. 22 , 24 , 25 In the study by Bialik et al, 26 98% of Graf IIa hips that were not treated developed to normal by age six months. Rosenberg and Bialik 27 reported normalization of six out of seven Graf IIa hips after follow-up of one year.…”

Section: Reports On Hips Classified According To Grafmentioning

confidence: 99%

“… 23 , 28 Of 400 hips that had Graf IIa hips at two months, 85% developed into Graf I by age three months. 22 , 23 , 28 …”

Section: Reports On Hips Classified According To Grafmentioning

confidence: 99%

The natural history of abnormal ultrasound findings in hips of infants under six months of age

Sakkers

Pollet

2018

Journal of Children's Orthopaedics

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PurposeTo collect and describe data on the natural history of abnormal ultrasound (US) findings in hips of infants under six months of age to serve as a reference to the design of screening programmes and treatment algorithms in the care for children with hip dysplasia.MethodsA search in PubMed of the terms “DDH” and “ultrasound” was done to find hips with abnormal US findings that were not treated. In cases of multiple periods of follow-up, the classification of every period was evaluated separately (individual hip follow-up periods).ResultsData of 13 561 hips with 16 991 follow-up periods were collected and analyzed. Most quantifiable classifications and follow-up periods were according to Graf (14 876) and a minor number of the hips had follow-up periods with femoral head coverage (FHC) (2115). Normal development without treatment in the first six months was for Graf 2a between 89% and 98%, for Graf 2c between 80% and 100% and for clustered data Graf 2a to 2c between 80% and 97%. For Graf 3 hips more than 50% were reported to develop into normal hips without treatment. As for Graf 4 hips this percentage was reported below 50%. For children with an FHC less than 50%, normalization was reported between 78% and 100%.ConclusionThe natural history of developmental dysplasia of the hip (DDH) shows a benign course, especially in the well-centered hips. This outcome probably contributes to the fact that all studies on US screening of hips for detection of relevant DDH in order to improve outcomes of treatment are rated as substantially underpowered.

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Can Medialization of Acetabular Rim Be a Prognostic Factor in Treatment of Developmental Dysplasia of Hip?

Koşar

Ergün

Gökharman

2021

J of Ultrasound Medicine

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Objectives-To investigate if acetabular rim medialization (ARM) can be used as a new parameter in determining the treatment choice and duration in Graf type III and IV hips.Methods-Among the 12,300 infants who underwent hip ultrasound (US) according to Graf's method between 2015 and 2019, 26 infants (9 had bilateral pathology hence 35 hips) with type III and IV hips, whose follow-up data could be obtained were included in the study. Age of the infants at the initial diagnosis, ARM measurement, the duration of harness treatment, and the treatment results were noted. To determine the extent of ARM, distance between a line that is drawn tangential to the iliac wing and acetabular rim was measured.Results-In cases with poor prognosis, ARM measurement was 6 to 8.5 mm on the right hip and 4 to 9 mm on the left hip. Bilaterality or unilaterality, left or right pathology, and gender did not have a significant effect on the prognosis (P >.05). Age at the initial diagnosis and ARM had significant effects on treatment success (P = .04, P = .00, respectively). In predicting the prognosis, ARM was found to be more successful than age (AUC = 0.95 versus AUC = 0.68). When these two variables were evaluated together, the success in predicting the prognosis significantly increased (AUC = 0.98).Conclusions-ARM measurement may have an important role in determining the treatment method and duration in Graf type III and IV hips. It can be used as a prognostic factor alone or in combination with treatment initiation time. When the two factors are combined, prognostic value significantly increases.

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Developmental Dysplasia in Male Infants: Risk Factors, Instability and Ultrasound Screening

Abstract: Risk factors do not have a statistically significant relationship with DDH in male cases. In our study 28% of the cases with DDH would be missed by a selective US screening protocol. We recommend assessment of all male infants with hip US.

Cited by 12 publications

References 26 publications

Late-presenting developmental dysplasia of the hip in Jordanian males

Late-presenting developmental dysplasia of the hip in Jordanian males

The natural history of abnormal ultrasound findings in hips of infants under six months of age

Can Medialization of Acetabular Rim Be a Prognostic Factor in Treatment of Developmental Dysplasia of Hip?

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