MEHMET FETHİ CEYLAN, SAVAŞ GÜNER, MEHMET ATA GÖKALP, ZEHRA KURDOĞLU, Abdurrahim GÖZEN, MEHMET FATİH KORKMAZ, Tülin TÜRKÖZÜ, HÜSEYİN AKDENİZ, OĞUZ TUNCER

Problems encountered in screening study with ultrasound for early diagnosis of developmental dysplasia of hip in eastern region of Turkey

The aim of this study is to evaluate results of the screening program of the development al dysplasia of the hip (DDH) examined in newborn period. The problems encountered in the applicability of the early screening program were e valuated. By interviewing with the family of 1680 newborns born in our institution or referred, the information was given about the DDH and its risk factors, obtained results were recorded. The families were told to bring their babies for examination and hip ultrasound at the 3rd or 4th week of birth. In addition, all the parents were called by telephone the day prior to their appointments. Five hundred and thirty-six babies (31.3%) were brought to the first appointment. Forty -two hips (3.9%) of the 30 infants (5.6%) were detected as dislocated (Type 2c, D, 3). The 8 of these 30 patients (26.7%) whom the treatment was started were brought for the second control. Asymmetry of thigh folds was positive in the highest rate as the finding of the examination in the infants brought to the appointment. The rate of swaddling at the first appointment was found to be 74.2%. Surprisingly, less than one third of children were brought to ultr asound examination at first control. Similarly, about 3/4 of the parents continued to use swaddling for their babies. For the success of national DDH screening program, additional precautions must be taken to ensure the participation of the families and re lease of the swaddling.

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1. Moosa NK, Kumar PT, Mahmoodi SM. Incidence of developmental dysplasia of the hip in Dubai. Saudi Med J 2009; 30: 952-955.

2. Tumer Y, Omeroğlu H. Prevention of developmental hip dysplasia in Turkey. Acta

3. Orthop Traumatol Turc 1997; 31: 176-181.

4. Songür M, Akel İ, Karahan S, Tümer Y. Prevalence of untreated hip dislocation in Turkish children aged 6 months to 14 years. Acta Orthop Traumatol Turc 2011; 45: 215-220.

5. Guner SI, Guner S, Peker E, et al. Are consanguineous marriage and swaddling the risk factors of developmental dysplasia of the hip? J Membr Biol 2013; 246: 115-119.

6. Tönnis D, Storch K, Ulbrich H. Results of newborn screening for CDH with and without sonography and correlation of risk factors. J Pediatr Orthop 1990; 10: 145-152.

7. Omeroğlu H, Koparal S. The role of clinical examination and risk factors in the diagnosis of developmental dysplasia of the hip: a prospective study in 188 referred young infants. Arch Orthop Trauma Surg 2001; 121: 7-11.

8. Shorter D, Hong T, Osborn DA. Cochrane Review: Screening programmes for developmental dysplasia of the hip in newborn infants. Evid Based Child Health 2013; 8: 11-54.

9. Turkish republican statistical institution data, internet access: http://www.tuik.gov.tr

10. Graf R. Hip sonography. Diagnosis and management of infant hip dysplasia. 2nd ed. Springer Verlag. New York 2006.

11. Mubarak SJ, Bialik V. Pavlik: the man and his method. J Pediatr Orthop 2003; 23: 342-346.

12. Bialik V, Bialik GM, Blazer S, et al.. Developmental dysplasia of the hip: a new approach to incidence. Pediatrics 1999; 103: 93-99.

13. Shaw BA, Segal LS, AAP Section on Orthopaedics. Evaluation and referral for developmental dysplasia of the hip in infants. Pediatrics 2016; 138: e20163107.

14. Demirhan M, Sar C, Aydinok HC, Cakmak M, Coban A. Ultrasonography in the diagnosis of congenital dislocation of the hip. Is newborn screening necessary? Acta Orthop Traumatol Turc 1994; 28: 8-14.

15. Mostert AK, Tulp NJ, Castelein RM. Results of Pavlik harness treatment for neonatal hip dislocation as related to Graf’s sonographic classification. J Pediatr Orthop 2000; 20: 306- 310.

16. Inoue T, Naito M, Nomiyama H. Treatment of developmental dysplasia of the hip with the Pavlik harness: factors for predicting unsuccessful reduction. J Pediatr Orthop B 2001; 10: 186-191.

17. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? World J Orthop 2015; 6: 886-901.

18. Peled E, Bialik V, Katzman A, Eidelman M, Norman D. Treatment of Graf’s ultrasound class III and IV hips using Pavlik’s method. Clin Orthop Relat Res 2008; 466: 825-829.

19. Von Kries R, Ihme N, Oberle D, et al. Effect of ultrasound screening on the rate of first operative procedures for developmental hip dysplasia in Germany. Lancet 2003; 362: 1883- 1887.

20. Uçar DH, Işiklar ZU, Kandemir U, Tümer Y. Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips. J Pediatr Orthop B 2004; 13: 70-74.

21. Sink EL, Ricciardi BF, Torre KD, Price CT. Selective ultrasound screening is inadequate to identify patients who present with symptomatic adult acetabular dysplasia. J Child Orthop 2014; 8: 451-455.

22. Wientroub S, Grill F. Ultrasonography in developmental dysplasia of the hip. J Bone Joint Surg Am 2000; 82: 1004-1018.

23. Woolacott NF, Puhan MA, Steurer J, Kleijnen J. Ultrasonography in screening for developmental dysplasia of the hip in newborns: systematic review. BMJ 2005; 330: 1413.

24. Ünsal SŞ, Ceylan MF, Güner S, et al. Results of open reduction and Salter innominate osteotomy for developmental dysplasia of the hip. East J Med 2015; 20: 187-191.

25. Kutlu A, Memik R, Mutlu M, Kutlu R, Arslan A. Congenital dislocation of the hip and its relation to swaddling used in Turkey. J Pediatr Orthop 1992; 12: 598-602.

26. Köse N, Omeroğlu H, Ozyurt B, et al. Our three-year experience with an ultrasonographic hip screening program conducted in infants at 3 to 4 weeks of age. Acta Orthop Traumatol Turc 2006; 40: 285-290.

27. Tosun HB, Bulut M, Karakurt L, Belhan O, Serbest S. Evaluation of the results of hip ultrasonography which applied for screening of developmental hip dysplasia. Fırat Medical Journal 2010; 15: 178-183.