The importance of the first ultrasonic exam of newborn hips.
BACKGROUND
Developmental hip disorder (DHD) is a disorder in development of the acetabulum which remains abrupt (dysplasia) and probably consequential cranialisation of the femur head (luxation).


OBJECTIVE
The aim of this paper is to establish the total number of DHD and its subtypes at the first clinical and ultrasound exam of newborns in a retrospective-prospective study made in the period from 1st Jan 2006 through to 31 Dec 2010 at the Clinic for orthopaedics and traumatology in Banja Luka.


METHODS
In total 6132 patients were examined and 99 cases diagnosed with DHD (dysplasia and luxation). Ultrasonic exam was done by means of electronic probe of 5-12 MHz according to standard method after Graph. Girls were significantly more present (96%). Positive family anamnesis on DHD was present with 7.8% examinee, mainly with primiparas, and/ or with 77.8% children with DHD. Dominant intrauterine risk factors for DHD were: mal position of foetus in uterus (78.6%), oligoamnion (17.9%), malformation of the spinal column of the pregnant woman (3.6%), whereas with 38.4% of children with a certain form of DHD the following were found: breech presentation, caesarean section or twin pregnancy. The clinical exam indicated DHD with 8.87% examinee, out of which hip looseness was found with 5% examinees. Ultrasonic finding was positive with 99 examinee, that is with 1.61% of them (deficient and badly formed acetabulum, sleeked protrusion; 8 luxations and 91 dysplasia). Prophylactic measures were requested by 58.6% children (abductive bending and exercises), whereas 41.4 % needed non-intervention therapeutic measures (traction, Pavlik's straps, Graph's knickers, plastering), after which there were no children needing surgical correction of DHD.


CONCLUSIONS
These data indicate that clinical exam is unreliable for DHD diagnostics, and that Ultrasonic diagnostics and treatment of DHD should start as early as possible applying atraumatic helping devices and procedures in the period when all structures are elastic, flexible and adaptable.
Department of Orthopaedics and Traumatology, Clinical Centre Banja Luka, Bosnia and Herzegovina. predraggrubor@gmail.com
Predrag
P
Grubor
Mithat
M
Asotic
Mirza
M
Biscevic
Milan
M
Grubor
D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000628:therapy; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D011247:Pregnancy; D014463:Ultrasonography