Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1736407
Prevalence of Developmental Dysplasia of the Hip in a Maternity Hospital in São Paulo, Brazil[*]
Article in several languages: português | English![](https://www.thieme-connect.de/media/10.1055-s-00042410/202105/lookinside/thumbnails/10-1055-s-0041-1736407_2000392_en-1.jpg)
Abstract
Objective To evaluate the prevalence of developmental dysplasia of the hip (DDH), that is, hips classified as Graf type-IIc or higher, among a sample of the population of newborns aged from 0 to 3 days of life, and to correlate the findings with the main risk factors described in the literature.
Methods An observational, cross-sectional, prospective study on a sample of newborns at a Maternity Hospital School in the city of São Paulo, Brazil, to assess the prevalence of DDH diagnosed by the Graf method and verify its correlation with the risk factors.
Results A total of 678 newborns underwent hip ultrasound (1,356 hips). The prevalence of DDH was of 5.46%. The logistic regression analysis showed odds ratios (ORs) with statistical significance for the following parameters: white ethnicity (OR = 2.561; 95% confidence interval [95%CI]: 1.07 to 6.11); multiparity (OR = 3.50; 95%CI: 1.62 to 7.38), female gender (OR = 4.95; 95%CI: 1.86 to 13.13); and breech presentation (OR = 2.03; 95%CI: 1,01 to 4.11).
Conclusion The prevalence of DDH in the sample was of 5.45% using ultrasound as a diagnostic method. This result is different from that of studies that assessed prevalence exclusively through physical examination (Ortolani maneuver). The main risk factors associated with a higher risk of developing DDH were newborns of the female gender, with breech presentation, firstborns, and of white ethnicity.
Author Contributions
GM: development of the instruments for data collection, data collection, initial analyses, conceptualization and study design, writing of the initial manuscript, and writing and revision of the final manuscript.
AC: review of the literature, and writing and revision of the manuscript.
EC: análysis and preparation of the data for the statistical analysis, and revision of the manuscript.
NV: contribution regarding the sections involving the clinical aspects of pediatric orthopedics and contribuition regarding the sections involving musculoskeletal radiology, and writing and revision of the manuscript.
MLD: writing and revision of the manuscript.
WI: conceptualization and study design, coordination and supervision of the data collection, writing of the initial manuscript, critical revision of the manuscript regarding important intellectual content, and writing and revision of the final manuscript.
* Work developed at Hospital e Maternidade Escola Dr. Mário de Moraes Altenfelder Silva, São Paulo, São Paulo, Brazil.
Publication History
Received: 30 October 2020
Accepted: 25 June 2021
Article published online:
28 October 2021
© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referências
- 1 Schaeffer EK, Study Group I, Mulpuri K. Developmental dysplasia of the hip: addressing evidence gaps with a multicentre prospective international study. Med J Aust 2018; 208 (08) 359-364
- 2 Guarniero R, Montenegro NB, Vieira PB, Peixinho M. Sinal de Ortolani: resultado do exame ortopédico em 9171 recém-nascidos na Associação Maternidade de São Paulo. Rev Bras Ortop 1988; 23 (05) 125-128
- 3 Ilfeld FW, Westin GW, Makin M. Missed or developmental dislocation of the hip. Clin Orthop Relat Res 1986; (203) 276-281
- 4 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008; 61 (04) 344-349
- 5 Morrissy RT, Weinstein SL. editors. Lovell and Winter's Pediatric orthopaedics. 4th ed.. Philadelphia, PA: Lippincott-Raven; 1996
- 6 Graf R. Hip sonography: background; technique and common mistakes; results; debate and politics; challenges. Hip Int 2017; 27 (03) 215-219
- 7 Palocaren T, Rogers K, Haumont T, Grissom L, Thacker MM. High failure rate of the Pavlik harness in dislocated hips: is it bilaterality?. J Pediatr Orthop 2013; 33 (05) 530-535
- 8 Barbosa RO, Albernaz EP. Perfil dos lactentes diagnosticados com displasia do desenvolvimento do quadril. Rev Bras Ortop 2018; 54 (05) 497-502
- 9 Ortiz-Neira CL, Paolucci EO, Donnon T. A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol 2012; 81 (03) e344-e351
- 10 Zhao L, Ma Q, Feng X. et al. Screening for Developmental Dysplasia of the Hip in Infants in Tibet Identifies Increased Prevalence Associated with Altitude. Med Sci Monit 2019; 25: 5771-5775
- 11 Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop 2011; 2011: 238607
- 12 Pollet V, Pruijs H, Sakkers R, Castelein R. Results of Pavlik harness treatment in children with dislocated hips between the age of six and twenty-four months. J Pediatr Orthop 2010; 30 (05) 437-442
- 13 Elbourne D, Dezateux C, Arthur R. et al; UK Collaborative Hip Trial Group. Ultrasonography in the diagnosis and management of developmental hip dysplasia (UK Hip Trial): clinical and economic results of a multicentre randomised controlled trial. Lancet 2002; 360 (9350): 2009-2017
- 14 Engesæter IØ, Laborie LB, Lehmann TG. et al. Prevalence of radiographic findings associated with hip dysplasia in a population-based cohort of 2081 19-year-old Norwegians. Bone Joint J 2013; 95-B (02) 279-285
- 15 Güler O, Şeker A, Mutlu S, Çerçi MH, Kömür B, Mahiroğulları M. Results of a universal ultrasonographic hip screening program at a single institution. Acta Orthop Traumatol Turc 2016; 50 (01) 42-48
- 16 El Jashi R, Gustafson MB, Jakobsen MB. et al. The association between gender and familial prevalence of hip dysplasia in Danish patients. Hip Int 2017; 27 (03) 299-304
- 17 Azzopardi T, Van Essen P, Cundy PJ, Tucker G, Chan A. Late diagnosis of developmental dysplasia of the hip: an analysis of risk factors. J Pediatr Orthop B 2011; 20 (01) 1-7
- 18 Lehmann HP, Hinton R, Morello P, Santoli J. Developmental dysplasia of the hip practice guideline: technical report. Committee on Quality Improvement, and Subcommittee on Developmental Dysplasia of the Hip. Pediatrics 2000; 105 (04) E57
- 19 Atalar H, Sayli U, Yavuz OY, Uraş I, Dogruel H. Indicators of successful use of the Pavlik harness in infants with developmental dysplasia of the hip. Int Orthop 2007; 31 (02) 145-150
- 20 Carlile GS, Woodacre T, Cox PJ. Verification of hip reduction using anterior ultrasound scanning during Pavlik harness treatment of developmental dysplasia of the hip. J Orthop 2014; 11 (04) 174-179
- 21 Kyung BS, Lee SH, Jeong WK, Park SY. Disparity between Clinical and Ultrasound Examinations in Neonatal Hip Screening. Clin Orthop Surg 2016; 8 (02) 203-209