The Frequency of Developmental Dysplasia of the Hip in Iraq and the Relationship between Clinical Versus Ultrasound Examination in Early Detection of Developmental Dysplasia of the Hip
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
Developmental Dysplasia of the Hip is a significant cause of disability in children and young adult it can result in gait abnormalities, chronic pain, degenerative arthritis and long term suffers. Early detection and early simple treatment prevent such disabilities and offer a less expensive mod of therapy. The rationale for this study was to highlight the frequency of Developmental Dysplasia of the Hip in a sample of Iraqi neonates based on clinical and ultrasound examination in addition to evaluate the disparity and the concordance between the clinical versus ultrasound examination for detection of early Developmental Dysplasia of the Hip in the neonatal period. A prospective screening study was done in Baghdad at the neonatal care unit of The Central Child teaching Hospital in a period of 22 months (from 3oth of January 2016 to 30th of November 2017). Clinical as well as ultrasonic examination was done at the same time to the hips of 500 neonates for early detection of Developmental Dysplasia of the Hip. Infants enrolled in this screening program were those healthy neonates aged less than 4 weeks before they discharged from the hospital, excluding infants with neuromuscular anomalies, congenital anomalies and those who were missed from the reevaluation visit. Infants with clubfoot and torticollis were included as these deformities considered to be risk factors of Developmental Dysplasia of the Hip. A total of 500 newborns participated in this study (232 were females and 268 were males). Only 2 neonates (3 hips) (0.4%) were diagnosed as DDH that needed the referral to orthopedic surgeon for treatment. Both were clinically (grade 3) and by sonography (Graf’s type IIc, III) during the 1st and 2nd visites. In other 2 neonates (0.4%) had unilateral subluxatable hips (grade 2 hips) clinically with normal sonography (Graf’s type I). Sixteen newborns (3.2%) had normal clinical examination but with unilateral different types of sonogram abnormalities (12 were Graf’s type IIc & 4 were type III). Those babies turned to be normal on follow up examination at the age of 5 to 8 weeks that need no treatment. The remaining 480 (96%) babies were normal both clinically and by sonography [253 (50.6%) Graf’s type I and 227 (45.4%) type IIa]. According to the present study, in the screening of early Developmental Dysplasia of the Hip, the frequency is 4 in 1000 in this sample of Iraqi neonates. There was high false positive result of developmental dysplasia of the hip diagnosed by U\S (84.2%) in comparison to clinical false positive results (60%) with high concordance between the 2 examinations in the second visit in comparison with the first one.
Authors and Affiliations
Dr. Amel Abdulnabi Hussein, Dr. Riyadh Mohammed Kadhim, Dr. Rabab Hassan Baaker
Keywords
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