Ultrasound in developmental dysplasia of the hip: A screening study in Sardinian newborns

Developmental dysplasia of the hip (DDH) is the most frequent inborn deformity of the locomotor apparatus. Ultrasound screening is frequently used to identify DDH in view of the brevity of the preclinical period during which diagnosis is possible. Appropriate therapeutic intervention during this period can positively affects the evolution of the disorder. Methods: An unselected population of 1158 Sardinian neonates underwent ultrasound examinations of both hips, and findings were classified according to the method described by Graf. Patients were assessed by means of retrospective analysis to reveal cases of congenital dislocation of the hip joint. All cases were classified and treatment outcomes determined. Results: A total of 145 hips requiring treatment were observed in 122 children. Hip dysplasia and/or dislocation were diagnosed between the ages of 14 days and 3 months. One month after diagnosis ultrasound findings were normal in 94% of the infants with at least one hip classified as type 2a. The remaining 6% were classified as types 2b, 2c, D, and 3. All were treated with abduction splints, and normal hip development was observed after one or two months of treatment. Type 4 hips were referred to an orthopedic surgeon for specialist treatment. Conclusions: When performed by skilled operators, ultrasonographic techniques are of considerable value in prescribing treatment for DDH. The satisfactory prognosis associated with early treatment of severe congenital dislocation of the hip joint underlines the advisability of scheduling routine hip screening programs to ensure early diagnosis and effective treatment of the disorder.