title: Incidence and treatment of developmental hip dysplasia in Mongolia: a prospective cohort study.
abstract: BACKGROUND
  In Mongolia, adequate early diagnosis and treatment of developmental hip dysplasia (DDH) have been unavailable and its incidence was unknown. We determined the incidence of ultrasonographic DDH in newborns and established adequate procedures for diagnosis and treatment of DDH at the largest maternity hospital in Ulaanbaatar, Mongolia.
  
  
  RESULTS
  During one year (Sept 2010 - Aug 2011) we assessed the hips newborns using ultrasound and Graf's classification of DDH. 8,356 newborns were screened; median age at screening was 1 day. We identified 14,873 Type 1 (89.0%), 1715 Type 2a (10.3%), 36 Type 2c (0.2%), 70 Type D (0.4%), 14 Type 3 (0.08%), and 4 Type 4 hips (0.02%). Children with Type 1 hips (normal) were discharged. Children with Type 2a hips (physiologically immature) received follow-up ultrasounds at monthly intervals. Children with Type 2c to 4 (DDH; deformed or misaligned hip joint) hips were treated with a Tubingen hip flexion splint and also followed up. The hip abnormalities resolved to mature hips in all children who were followed up. There was no evidence for severe treatment related complications.
  
  
  CONCLUSIONS
  This study suggests that the incidence of DDH in Mongolian neonates is comparable to that in neonates in Europe. Early ultrasound-based assessment and splinting treatment of DDH led to mature hips in all children followed up. Procedures are feasible and will be continued.
authors.affiliation: National Center for Maternal and Child Health, Ulaanbaatar, Mongolia.
authors.forename: Bayalag
authors.initials: B
authors.lastname: Munkhuu
authors.forename: Stefan
authors.initials: S
authors.lastname: Essig
authors.forename: Erdenesuvd
authors.initials: E
authors.lastname: Renchinnyam
authors.forename: Raoul
authors.initials: R
authors.lastname: Schmid
authors.forename: Corina
authors.initials: C
authors.lastname: Wilhelm
authors.forename: Julia
authors.initials: J
authors.lastname: Bohlius
authors.forename: Battulga
authors.initials: B
authors.lastname: Chuluunbaatar
authors.forename: Enkhtur
authors.initials: E
authors.lastname: Shonkhuuz
authors.forename: Thomas
authors.initials: T
authors.lastname: Baumann
mesh_terms: D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008403:Mass Screening; D008986:Mongolia / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013165:Splints; D014463:Ultrasonography