O. Ruhmann et al., Ultrasound screening in newborns: The influence of anamnestic risk factorsto congenital dysplasia of the hip, Z ORTHOP GR, 136(6), 1998, pp. 492-500
Introduction: Hereditary, pelvic respectively breech presentation or abdomi
nal delivery, premature as well as post-term birth and twin pregnancy are c
onsidered to be anamnestic risk factors for congenital dysplasia of the hip
. The results of ultrasound hip screening of two University hospitals are p
resented with special regard to the correlation of these risk factors and t
he occurrence of pathologic hips.
Patients/methods: 24 different physicians of the orthopaedic departments ex
amined the hips of 6617 newborns (female: 3253 - 49,2%; male: 3364 - 50,8%)
by ultrasound (screening). 94,6% of the examinations were performed within
a period of 5 days after birth. The ultrasound examinations, the assessmen
t of the echograms and classification into types of hip were performed acco
rding to Graf's technique. All investigations were assessed retrospectively
over the period of time with the help of documentation forms (data of newb
orn baby, case history, clinical and sonographical findings, kind of therap
y and procedure) and statistically checked (Chi-Quadrate-test).
Results: In 436 children (6,6%) we found hips required therapy respectively
control investigations (type IIa, a<55 degrees or worse; Graf's classifica
tion). For the entire group we achieved the following types of hips (right/
left side): Ia - 724 (10,9%)/645 (9,8%); Ib - 3931 (59,4%)/3892 (58,8%); II
a(greater than or equal to 55 degrees)- 1733 (26,2%)/1768 (26,7%); IIa (<55
degrees) - 143 (2,2%)/181 (2,7%); IIc - 55 (0,8%)/77 (1,2%); D - 20 (0,3%)
/39 (0,6%); IIIa - 9 (0,1%)/11 (0,2%); IIIb - 1 (<0,1%)/3 (0,1%); IV - 1 (<
0,1 %)/I (<0,1%).
Conclusions: In newborn babies with cases of hip dysplasia in their family
(heredity) and pelvic respectively breech presentation at birth, as well as
for girls and the left side we found a significant higher rate (p < 0,05)
of hips required therapy respectively control investigations (type IIa, alp
ha<55 degrees or worse; Graf's classification), A correlation of the other
mentioned risk factors premature respectively post-term birth, twin pregnan
cy and cases of abdominal delivary without breech presentation was not evid
ent.