Fundamentals of Sonographic Diagnosis of Infant Hip Dysplasia

Graf, Reinhard

doi:10.1097/01241398-198411000-00015

Cited by 311 publications

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“…Hip ultrasonography (USG) provides early detection of DDH by visualizing both the bony and cartilaginous parts of the newborn hip joint [3]. The risk of missing the DDH diagnosis by hip USG is less than 0.1 % [4].…”

Section: Introductionmentioning

confidence: 99%

“…Graf type IIa hip is called a ''physiologically immature hip'' in which a certain degree of physiological maturation delay occurs in the bony acetabular roof. The alpha angle is between 50°and 59°, the beta angle is between 55°and 77°, and the patient is younger than 12 weeks of age [3]. There are two subtypes of type IIa hip; type IIa(?)…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonographic Graf type IIa hip needs more consideration in newborn girls

Ömeroğlu

Çaylak

İnan

et al. 2013

Journal of Children's Orthopaedics

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Purpose According to hip ultrasonography by Graf’s method, the type IIa hip has a certain degree of physiological delay in ossification of the bony acetabular roof. The aim of this case–control study was to evaluate the natural history of the type IIa hip. Methods Four hundred and thirty-one type IIa hips were identified in 312 of 1,690 ultrasonographically screened newborns with a mean age of 27 days. Parents were accurately informed about the prognosis of such a hip condition and invited for ultrasonographic re-examination at 6–7 weeks of age. Results Type IIa hip was more common in newborn girls than in boys (P < 0.001). Among 431 type IIa hips, 146 (34 %) missed the follow-up examination at 6–7 weeks of age. Among the completely followed 285 hips, 225 (79 %) developed into a normal hip at 6–7 weeks of age. Newborn boys’ hips had a higher rate of spontaneous normalization than girls’ hips at 6–7 weeks of age (P = 0.006). All but one type IIa(+) hip became type I without any treatment. According to our management protocol, 35 type IIa(−) hips and one type IIa(+) hip, which later became type IIb, underwent treatment. The rate of treatment was higher in newborn girls’ hips than in boys’ hips (P = 0.019). Conclusions As Graf type IIa hip is more common, has a lower rate of spontaneous normalization and higher rate of treatment in newborn girls than in boys, we recommend paying more attention the type IIa hip in newborn girls. The rate of missing the required follow-up is unacceptably high due to parents’ insensitivity regarding the type IIa hip.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Graf type IIa hip needs more consideration in newborn girls

Ömeroğlu

Çaylak

İnan

et al. 2013

Journal of Children's Orthopaedics

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“…Developmental dysplasia of the hip (DDH) remains a perplexing and unsolved problem in older children [14] and older children with DDH are more difficult to treat [10,11]. Treatment modalities include various nonoperative or operative approaches (open reduction, and pelvic or femoral osteotomies) [6,12,18].…”

Section: Introductionmentioning

confidence: 99%

Outcome in Unilateral or Bilateral DDH Treated with One-stage Combined Procedure

Subaşı

Arslan

Cebesoy

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…It is related to ethnic affiliation as well. DDH is unknown among the Bantu, and it is a very common condition among the aboriginal Canadians (12.3%) due to traditional swaddling (11,13).…”

Section: Discussionmentioning

confidence: 99%

Value of the First Examination for Developmental Dysplasia of the Hip - Our Experiences

Grubor¹,

Grubor²,

Domuzin³

et al. 2012

Acta Facultatis Medicae Naissensis

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Developmental dysplasia of the hip (DDH) means a distinct dislocation (lateralisation and cranialisation) of the femoral head from the poorly developed (hypoplastic and steeper) acetabulum.The aim of the paper was to establish, in a retrospective and prospective study conducted in the period between January 1, 2006 and December 31, 2010, the total number and characteristics of instances of DDH in the first clinical and ultrasound examinations in newborns examined at the Traumatology Clinic of the Clinical Centre in Banja Luka.Six thousand one hundred thirty-two children were examined and 99 were treated. The percentage of girls among the treated children was considerably higher (96%). The ultrasound examination was performed first and was followed by the clinical examination. The ultrasound examination of all babies was performed with an electronic 5-12-MHz probe, using the standard Graf's method.7.8% of the cases, mostly primiparae, had a positive family history of DDH. The incidence diagnosed clinically amounted to 8.87%, and the incidence diagnosed by ultrasound to 1.61%. The first clinical examination diagnosed a limited abduction of the right hip in 12.1% of the newborns, while limited abduction of the left hip was present in 96.0%. Ortolani's sign in the right hip was positive in 3.0% and in 33.3% patients it was positive in the left hip. 3.0% of the newborns had a positive Palmen sign in the right hip in the first examination, and 42.4% in the left. 3% of the patients had asymmetric skin creases on the right upper leg, while 87.9% of the patients had them on the left upper leg. 46.5% of the patients had crepitations in their right hip, while 83.8% had crepitations in the left hip. 2% of the patients had a lax right hip, while 3% had a lax left hip. The results obtained from the ossified acetabulum of the right hip in the examined sample were as follows: good in 91.9%, satisfactory in 5.1%, insufficient (deficient) in 2.0%, and bad in 1.0% of the cases. The results from the left ossified acetabulum were as follows: good in 3.0%, satisfactory in 44.4%, insufficient (deficient) in 45.5 %, bad in 7.1% of the cases. The bony protrusion -acetabular labrum on the right hip was angular in 90.9%, obtuse (fused) in 1.0%, round in 7.1%, round to flat and flat in 1.0% of the cases. The bony protrusion -acetabular labrum on the left hip was angular in 2.0 %, obtuse (fused) in 2.0%, round in 81.8%, round to flat and flat in 14.1% of the cases.It is important to commence with diagnosing and treating DDH as early as possible by applying atraumatic aids and procedures while all structures are elastic, reducible and adaptable.The clinical examination is unreliable in terms of diagnosis of DDH, but it is mandatory as a part of the full physical examination of a newborn baby.

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Fundamentals of Sonographic Diagnosis of Infant Hip Dysplasia

Cited by 311 publications

References 0 publications

Ultrasonographic Graf type IIa hip needs more consideration in newborn girls

Ultrasonographic Graf type IIa hip needs more consideration in newborn girls

Outcome in Unilateral or Bilateral DDH Treated with One-stage Combined Procedure

Value of the First Examination for Developmental Dysplasia of the Hip - Our Experiences

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