Clinical value of asymmetric skin folds for screening of developmental dysplasia of the hip in infant / 中华实用儿科临床杂志

ABSTRACT

Objective@#To investigate the clinical significance of asymmetric skin folds in the diagnosis of developmental dysplasia of the hip (DDH) in infant.@*Methods@#The clinical data of 3 266 infants aged up to 6 months who were evaluated because of suspicious findings for DDH, hospitalized at Department of Pediatric Orthopaedics, Shengjing Hospital of China Medical University between January 2012 and April 2019 were reviewed retrospectively, including 1 185 boys and 2 081 girls, with a mean age of 2.8 months (ranging from 1 d to 6 months). The referred reasons included regular screening for DDH without suspicious findings [379 cases(11.6%)], clunk of the hip[59 cases(1.8%)], limb-length discrepancy[188 cases (5.8%)], limitation of hip motion or asymmetrical range of motion[58 cases(1.8%)], asymmetric skin folds[2 107 cases(64.5%)], and combined conditions of musculoskeletal disorder[475 cases(14.5%)]. The Graf′s ultrasound method was used to define the hip conditions.A type Ⅰ or Ⅱa hip was graded as normal, and a type Ⅱb or more serious was graded as DDH.The percentages of DDH for various reasons were compared.@*Results@#Among 3 266 patients (6 532 hips), a total of 194 infants(230 hips)were diagnosed as DDH, and the total diagnostic rate was 5.94%, including 31 males and 163 females; there were 109 cases involving in the left, 49 cases in the right, and 36 cases in the bilateral.The DDH diagnosed rate for regular screening was 8.71%(33/379 cases), 6.78%(4/59 cases) for clunk of the hip, 10.34%(6/58 cases) for limitation of hip motion, 14.36%(27/188 cases)for limb-length discrepancy, 4.79%(101/2 107 cases) for asymmetric skin folds, 4.84%(23/475 cases) for combined conditions of musculoskeletal disorder, and the DDH diagnosed rate for asymmetric skin folds was the lowest(χ2=37.14, P<0.05).@*Conclusions@#Although asymmetric skin folds is the most common reason for DDH screening in infant up to 6 months, its clinical significance is limited, asymmetric skin folds should not be considered as an independent indication for DDH screening.