DEVELOPMENTAL DYSPLASIA OF THE HIP - A POPULATION-BASED COMPARISON OFULTRASOUND AND CLINICAL FINDINGS

Citation
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
Citations number
38
Categorie Soggetti
Pediatrics
Journal title
ISSN journal
08035253
Volume
85
Issue
1
Year of publication
1996
Pages
64 - 69
Database
ISI
SICI code
0803-5253(1996)85:1<64:DDOTH->2.0.ZU;2-G
Abstract
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.