Evaluation of ultrasound screening method and prevalence for developmental hip dysplasia in the central Anatolia

Authors : Oğuzhan Pekince, Ferhat Sayar, Emrah Cevat Ercan, Özkan Köse

Pages : 486-496

Doi:10.31362/patd.1412442

View : 49 | Download : 91

Publication Date : 2024-07-05

Article Type : Research Paper

Abstract :Purpose: This study aims to evaluate the incidence and follow-up outcomes of Developmental Hip Dysplasia (DDH) in infants admitted to City Hospital using the Graf classification. Furthermore, it aims to investigate the prevalence of DDH in Central Anatolia and assess the effectiveness of current screening and treatment protocols for detecting and managing DDH in infants. Materials and methods: A total of 10.650 infants underwent screening for DDH using the Graf USG method as part of the National DDH screening program at City Hospital between August 2020 and September 2022. Infants born at term (38 weeks and above) and screened between 30-90 days of birth were included, while premature infants were excluded. Hips were classified according to the Graf method into Types 1 (normal), 2 (immature), 2A (+), 2A (-), 2B, 2C, D, 3, and 4, based on alpha angles. Results: The study examined the USG results of 8,695 term infants (52.5% male and 47.5% female) between 2020 and 2022. The mean gestational age of participants at the time of the initial USG examination was approximately 7.94±2.07 weeks. Graf Type 1 was more prevalent in males (97-96.5%), while Graf Type 2 was more common in females (7.2-7.8%). Radiologists tended to recommend a re-examination after one month for Type 2A Graf hips (84.49-82.02%), whereas orthopedic consultation was advised for Type 2B, 2C, and Type 3 hips. The vast majority of infants (93.6%) underwent only one USG screening. Pelvic X-ray was requested for 15.9% of patients, and additional USGs were requested for 5.7% of patients. Pavlik treatment was applied to 4.2% of patients who did not return to normal, Frejka pillow treatment was applied to 1.5% Interestingly, none of the patients who maintained regular USG monitoring and treatment required surgical intervention involving osteotomy. Conclusion: USG is an early diagnostic method for DDH, which allows for simple treatment options and the prevention of complications. It is a simple, inexpensive, and non-invasive method. Our study supports that regular USG screenings in infants eliminate the need for surgical procedures requiring osteotomy. However, the proportion of individuals who failed to adhere to their follow-up appointments despite receiving abnormal results remains elevated, underscoring the necessity for implementing diverse strategies aimed at augmenting parental awareness in this context.
Keywords : Gelişimsel kalça displazisi, Anadolu, prevalans, ultrason tarama metodu