Sanamed (Jan 2017)
Results of ultrasound screening of the hips in newborns and infants
Abstract
The aim of this study is to analyze the results of ultrasound screening of the hips in newborns and infants and to establish the importance of ultrasonography in early diagnosis and treatment of developmental dysplasia of the hips (DDH). Material and Methods: In 2010, at the Clinic for orthopedic surgery in Skopje, 6333 newborns and infants were examined. They were classified in 2 groups: first group consisted of patients with normal ultrasound findings and second group consisted of patients with DDH on ultrasound finding. Patients underwent clinical examination and ultrasonography of the hips. Results: We examined 6333 newborns and infants up to 6 months of age. 3213 were female and 3120 were male. In the first group there were 5932 (93.67%) patients with normal ultrasound of the hip-Graf Type 1. In the second group there were 401 (6.33%) patients with DDH on ultrasound. The patients of the second group were divided in 3 types according to Graf method. Graf Type 2-Patients with dysplasia 378 (5.97%) subdivided in 2a- 260 (4.11%) patients, 2b 85 (1.34%) patients and 2c 33 (0.52%) patients. Graf Type 3 - Patients with subluxation of the hip 9 (0.1%), subdivided in 3a 3 (0.05%) patients and 3b 3 (0.5%) patients. Graf Type 4 -Patients with luxation of the hip 17 (0.27%) patients. 124 patients (30.5%) with DDH had an associated risk factors (65 patients with positive family history, 48 patients with breech delivery and 11 patients with clubfoot deformity). 387 patients with dysplasia and subluxation of the hips were treated with abduction brace and Pavlik harness. 17 patients with luxation of the hips were treated with exercises and overhead traction of the muscles, close reduction of the hip placed in spica cast or open reduction. Conclusion: Ultrasound screening of hips in newborns and infants is important for early diagnosis of DDH. This is necessary for adequate treatments. If this disease is not treated properly it gives long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. Analysis of the results of ultrasound screening of the hips in our population showed that there is a significant number of dysplastic hips.
