Evaluation of the Effectiveness of Developmental Hip Dysplasia Screening in Risk Groups

Condition(s) studied

Investigational drug(s) / intervention(s)

x ray: we performed pelvis ap and frog leg x ray to child in 6 month and 1 age

ultrasound: we will perform ultrasound in 6 week and 3 month

Study summary

This study is a non-drug clinical trial.

Developmental dysplasia of the hip (DDH) encompasses a spectrum of hip developmental disorders, including dislocation, subluxation, and acetabular dysplasia. DDH is among the most prevalent hip conditions in infants. Dislocation is defined as the incomplete displacement of the hip joint, and residual dislocation due to DDH is associated with pain and severe osteoarthritis of the hip in young adulthood.

The progression of DDH is dynamic and may improve or worsen depending on various factors. The primary determinant of prognosis is the concentric reduction of the hip joint, with the femoral head needing to be reduced to allow for normal acetabular development.

DDH is the most common orthopedic condition in the neonatal period. According to the literature, the incidence is approximately 1:100 for dysplasia and 1:1000 for dislocation. However, estimates suggest that dislocation rates in Türkiye may reach 5-15:1000. DDH occurs six times more frequently in girls than boys and is more commonly observed in the left hip. Established risk factors for DDH include being a first-born girl, Caucasian race, positive family history, oligohydramnios, multiple pregnancies, in utero breech presentation, pes calcaneovalgus, metatarsus adductus, and torticollis.

Early detection and treatment of dislocation caused by DDH are associated with success rates exceeding 80%. However, diagnosis and treatment initiation after one year of age often result in variable outcomes. Literature indicates that clinical and sonographic evaluations may be normal at six weeks in breech patients-who are at significant risk for DDH-yet hip dysplasia may still develop in this population later. The investigators aim to contribute to existing literature by evaluating whether sonographic screening alone is sufficient or if additional screening methods are warranted for patients with identified DDH risk factors.

Eligibility

Primary outcome measure(s)

• Acetabular Index Variation Measured by Tönnis Grading System — At 6 months and 1 year of age
  The change in acetabular index will be assessed using pelvic anteroposterior(AP) and frog-leg lateral x-rays. Measurements will be analyzed according to the classification system. The unit of measure will be degrees(°).

Trial sites (1)

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