[Ultrasound monitoring of the orthopaedic treatment of congenital hip dysplasia carried out within the first 6 months of life].
BACKGROUND
The use of ultrasound scanning in the early diagnosis of congenital hip dysplasia in infants within the first six months of life has become part of the routine in preventive medicine examinations. Ultrasound scanning makes it possible to monitor the development of the neonatal dysplasic hip at any moment and it also tells us whether or not it is responding to treatment and, if it is not, to modify the treatment in order to achieve cure.


METHODS
The present study considers pathological hips studied echographically over 12 years in order to assess to what extent ultrasound controls during treatment have influenced the choices and modifications of treatment. The study employed different echographic equipment always with 5 or 7.5 MHz linear probes; the evaluation technique employed was that proposed by Graf. Echography evaluation was always proceded by clinical assessment and followed at the end of treatment by X-ray control of the pelvis.


RESULTS
Of 17,938 hip cases assessed echographically from 1 January 1989 to 31 December 2000 (59.5% female and 40.5% male, average age 3 months 17 days) 1534 hips were pathological (IIC, IID, IIIA, IIIB); the prevalence of the condition in females and on the left-hand side was confirmed. In 35 cases (2.19%) the orthopaedic treatment approach undertaken at the beginning was changed on the basis of periodic scans. The normalisation of the alpha angle was achieved on average in 51 days of treatment with the harness; with a minimum time of 30 days in IIC type hips in patients below the age of three months and a maximum time of 98 days in hips of type IIIA in patients aged more than 120 days.


CONCLUSIONS
The simplicity and ease of use of ultrasound scanning, its cheapness, rapidity, harmlessness and validity not to mention its sensitivity and specificity make it a reliable, safe instrumental examination that is indispensable in planning the treatment of this pathology.
Azzoni
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Clinica Ortopedica, Istituto di Scienze Medico-Chirurgiche San Donato, Università degli Studi di Milano, Istituto Policlinico San Donato, San Donato Milanese (MI), Italy.
Cabitza
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D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019637:Orthopedic Procedures; D009989:Orthotic Devices; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography