K. Rosendahl et al., DEVELOPMENTAL DYSPLASIA OF THE HIP - A POPULATION-BASED COMPARISON OFULTRASOUND AND CLINICAL FINDINGS, Acta paediatrica, 85(1), 1996, pp. 64-69
Clinical and ultrasound findings were compared in 3613 newborns examin
ed for developmental dysplasia of the hip (DDH) within 48 hours of del
ivery. Clinical and sonographic hip stability was described as stable,
borderline unstable, dislocatable or dislocated, and the morphology o
n ultrasound as normal, immature or dysplastic. Persistent clinical or
sonographic dislocatability or dislocation, major dysplasia or minor
dysplasia combined with an unstable femoral head were indications for
early treatment. A total of 123 (3.4%) infants were subjected to early
treatment, of which 55 (45%) fulfilled the criteria for treatment on
both clinical and ultrasound examinations, 52 (42%) were treated on th
e basis of ultrasound findings alone, and 16 (13%) on the basis of cli
nical findings alone. Thirty per cent of the infants with clinically d
islocated or dislocatable hips were judged to have stable or just bord
erline unstable hips on the first clinical examination. Of 486 (13.5%)
infants with sonographically immature or minor dysplastic but stable
hips, 472 (97%) normalized spontaneously, while treatment was initiate
d in 14 (3%) of them at 1-3 months of age because of lack of sonograph
ic improvement. Only one infant presented with late DDH during an obse
rvation period of 3 years. Accepting sonographic dysplasia as a criter
ion for early splinting may result in a treatment rate which is almost
twice the rate based on clinical criteria, but late dislocation may b
e virtually eliminated.