title: Sonographic hip screening and early management of developmental dysplasia of the hip.
abstract: The reliability of Graf's technique in diagnosing developmental dysplasia of the hip (DDH) is investigated in this report. In a prospective study, 6,548 neonates were examined clinically and sonographically; 470 children were reexamined at least once. Sonographic alpha angles and radiographic acetabular index (AI) angles were followed up and compared. Results were as follows: 84.6% of the hips were mature; 14.3% were physiologically immature; 1.1% were dysplastic. Of the sonographically dysplastic hips, 63% were clinically 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 spontaneously, and 11% needed abduction. The 68 dysplastic hips had matured after a maximum of 80 days' abduction, with normal alpha and AI angles by the end of treatment. At 1 year, the pitch had deteriorated again in six children. Graf's sonographic technique reliably diagnoses infantile DDH. Regular orthopedic checkups are needed to detect secondary deterioration of dysplastic hips.
authors.affiliation: Department of Orthopaedics, Kiel University Hospital, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Falliner
authors.forename: H J
authors.initials: HJ
authors.lastname: Hahne
authors.forename: J
authors.initials: J
authors.lastname: Hassenpflug
mesh_terms: D001724:Birth Weight; D001946:Breech Presentation; D005260:Female; D005865:Gestational Age; D006618:Hip Dislocation, Congenital / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D010808:Physical Examination / Q000379:methods*; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013165:Splints; D013997:Time Factors; D014463:Ultrasonography