Ultrasound screening of at risk infants optimizes conservative management and can reduce the rate of surgery in developmental dyspalsia of Hip

ABSTRACT

To determine the usefulness of ultrasound screening of only at risk infants in the management of developmental dysplasia of hip [D.D.H.]. All live births, [9310], were examined by a neonatologist within 24 hours of birth. The infants with unstable hips on clinical examination, clicking hips, family history, breech presentation [vaginal delivery and caesarean sections] and those with concurrent congenital deformity were then seen in the D.D.H. clinic, within 3 weeks of birth .The infants were classified according to the ultrasound appearance of their hips. Graf's typing was used and formed the basis for conservative and surgical management. There were 218 Grade I, normal babies. There were 89 dysplastic hips in 83 patients. 51 Grade II, 23 Grade III and 15 Grade IV dysplasias. During the study of 23 months of study only 3 hips, all with an initial type 1V ultrasound appearance were unresponsive to conservative measures and required open surgery. Ultrasound screening of babies at risk and those with unstable hips on clinical examination optimizes conservative management and can reduce the rate of open surgical intervention in D.D.H