Sonographic hip screening and early management of developmental dysplasia of the hip

The reliability of Graf's technique in diagnosing developmental dysplasia o f the hip (DDH) is investigated in this report. In a prospective study, 6,5 48 neonates were examined clinically and sonographically; 470 children were reexamined at least once. Sonographic alpha angles and radiographic acetab ular index (AI) angles were followed up and compared. Results were as follo ws: 84.6% of the hips were mature; 14.3% were physiologically immature; 1.1 % were dysplastic. Of the sonographically dysplastic hips, 63% were clinica lly normal. Neonatal sonographic hip status was affected by family history, breech delivery, birth weight, and gestational age. At follow-up, none of the primarily mature hips had worsened. Of the type IIa hips, 89% matured s pontaneously, and 11% needed abduction. The 68 dysplastic hips had matured after a maximum of 80 days' abduction, with normal alpha and AI angles by t he end of treatment. At 1 year, the pitch had deteriorated again in six chi ldren. Graf's sonographic technique reliably diagnoses infantile DDH. Regul ar orthopedic checkups are needed to detect secondary deterioration of dysp lastic hips.