title: Late-presenting developmental dysplasia of the hip in Jordanian males. A retrospective hospital based study.
abstract: OBJECTIVE
  To describe the pattern of developmental dysplasia of the hip (DDH) in late presenting Jordanian male patients and identify the risk factors and associated findings.
  
  
  METHODS
  This is a retrospective study of 1145 male patients who attended the Pediatric Orthopedic Clinic for a DDH check up. This study was carried out in the Orthopedic Section, Special Surgery Department, Faculty of Medicine, The University of Jordan, Amman, Jordan between March 2011 and October 2014. Data was collected from medical records, and x-ray measurements were evaluated.
  
  
  RESULTS
  Of the 1145 male patients, 43 (3.75%) with 70 involved hips were diagnosed with late- presenting DDH. Being a first-born baby resulted in 41.9% increased risk for DDH. Cesarian delivery was significantly associated with an increased risk of hip dislocation (p=0.004) while normal delivery was significantly associated with acetabular dysplasia (p=0.004). No predictable risk factors were found in 44.2% patients with DDH. Bilateral cases were more common than unilateral cases: (26 [60.5%] versus 17 [39.5%]). Limited abduction was a constant finding in all dislocated hips (p less than 0.001). Associated conditions, such as club foot and congenital muscular torticollis were not observed.
  
  
  CONCLUSIONS
  Cesarian section is a significant risk for dislocated hips while normal delivery is significantly associated with acetabular dysplasia. Bilateral DDH is more common than the unilateral. Club foot and torticollis were not observed in this series.
authors.affiliation: Orthopedic Section, Special Surgery Department, Faculty of Medicine, The University of Jordan, Amman, Jordan. E-mail. o.samarah@ju.edu.jo.
authors.forename: Omar Q
authors.initials: OQ
authors.lastname: Samarah
authors.forename: Fadi A
authors.initials: FA
authors.lastname: Al Hadidi
authors.forename: Mohammad Q
authors.initials: MQ
authors.lastname: Hamdan
authors.forename: Ashraf T
authors.initials: AT
authors.lastname: Hantouly
mesh_terms: D000077:Acetabulum / Q000002:abnormalities*; D001722:Birth Order; D002585:Cesarean Section / Q000706:statistics & numerical data*; D057210:Delayed Diagnosis; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006618:Hip Dislocation, Congenital / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007597:Jordan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
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