ABSTRACT
Background: Developmental dysplasia of the hip [DDH] is one of the most common congenital malformations and it is an important cause of childhood disability
Aim of this study: Selective screening for DDH in neonates with breech presentation and evaluating the effectiveness of ultrasound use in diagnosis of DDH
Patient and Methods: A cross-sectional study in phase I and a prospective study in its phase II, was conducted on 268 full term and near term breech neonates born in Obstetrics and Gynecology Hospital of Ain Shams University, in the period from March 2013 to February 2014. All included subjects were subjected to: Full history taking, thorough clinical examination and ultrasonographic assessment of the hip joint using the static and dynamic method
Results: The overall final incidence of the disease was 3%. The frequency of the disease was highest in female gender [male: female was 1: 3]. Twenty one cases [7.8%] were defined as pathological according to the clinical examination, 15 of them [71%] were defined as pathological according to ultrasonography [USG] and 6 cases [29%] had normal findings. 247 newborns [92.2%] had normal clinical examination, of these clinically normal neonates sonographic abnormalities were found in 36 [14.5%]. Considering ultrasonography as a gold standard method in evaluating DDH, the sensitivity and specificity of clinical examination were determined 25.6% and 96.8%, respectively. Among the possible risk factors significantly associated with DDH, oligohydrammos was the only risk factor significantly associated with DDH
Conclusion: The incidence of DDH in breech presented neonates is variable and clinical examination does not reliably detect ultrasonographically defined DDH in infants being screened for this disease, so routine screening should be done with clinical examination and with US to all of them because early intervention is better and cheaper with less complication