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Acetabular dysplasia at the age of 1 year in children with neonatal instability of the hip.

Wenger D, Düppe H, Tiderius CJ - Acta Orthop (2013)

Bottom Line: Screening and early treatment of neonatal instability of the hip (NIH) reduces the incidence of DDH.Even in children who are diagnosed and treated perinatally, radiographic differences in acetabular shape remain at 1 year.To determine whether this is of clinical importance, longer follow-up will be required.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics , Malmö, Skåne University Hospital , Sweden.

ABSTRACT

Background and purpose: As much as one-third of all total hip arthroplasties in patients younger than 60 years may be a consequence of developmental dysplasia of the hip (DDH). Screening and early treatment of neonatal instability of the hip (NIH) reduces the incidence of DDH. We examined the radiographic outcome at 1 year in children undergoing early treatment for NIH.

Subjects and methods: All children born in Malmö undergo neonatal screening for NIH, and any child with suspicion of instability is referred to our clinic. We reviewed the 1-year radiographs for infants who were referred from April 2002 through December 2007. Measurements of the acetabular index at 1 year were compared between neonatally dislocated, unstable, and stable hips.

Results: The incidence of NIH was 7 per 1,000 live births. The referral rate was 15 per 1,000. 82% of those treated were girls. The mean acetabular index was higher in dislocated hips (25.3, 95% CI: 24.6-26.0) than in neonatally stable hips (22.7, 95% CI: 22.3-23.2). Girls had a higher mean acetabular index than boys and left hips had a higher mean acetabular index than right hips, which is in accordance with previous findings.

Interpretation: Even in children who are diagnosed and treated perinatally, radiographic differences in acetabular shape remain at 1 year. To determine whether this is of clinical importance, longer follow-up will be required.

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The incidence of NIH in Malmö during the study period. 15‰ of all children born in Malmö were referred because of suspected NIH. 5‰ had a dislocated hip. 2‰ had an unstable hip. 8‰ had bilaterally stable hips. This is comparable to previously published data from 1990–97 (Danielsson 2000). Numbers in parentheses denote the percentage of girls in each group.
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Figure 3: The incidence of NIH in Malmö during the study period. 15‰ of all children born in Malmö were referred because of suspected NIH. 5‰ had a dislocated hip. 2‰ had an unstable hip. 8‰ had bilaterally stable hips. This is comparable to previously published data from 1990–97 (Danielsson 2000). Numbers in parentheses denote the percentage of girls in each group.

Mentions: From April 2002 through December 2007, there were 22,517 live births at our hospital and 332 children were referred for examination at our clinic. The incidence of referral was 15/1,000 live births (Figure 3). Of all the children referred, 241 (73%) were girls. 111 children (91 of whom were girls) were treated with the von Rosen splint for 12 weeks. 47 children (40 girls) were treated for 6 weeks. 173 of those referred (110 girls) had bilaterally stable hips. Of the 111 cases with dislocation, 38 (34%) were bilateral, 16 (14%) had an unstable contralateral hip, and 57 (51%) had a stable contralateral hip.


Acetabular dysplasia at the age of 1 year in children with neonatal instability of the hip.

Wenger D, Düppe H, Tiderius CJ - Acta Orthop (2013)

The incidence of NIH in Malmö during the study period. 15‰ of all children born in Malmö were referred because of suspected NIH. 5‰ had a dislocated hip. 2‰ had an unstable hip. 8‰ had bilaterally stable hips. This is comparable to previously published data from 1990–97 (Danielsson 2000). Numbers in parentheses denote the percentage of girls in each group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3822134&req=5

Figure 3: The incidence of NIH in Malmö during the study period. 15‰ of all children born in Malmö were referred because of suspected NIH. 5‰ had a dislocated hip. 2‰ had an unstable hip. 8‰ had bilaterally stable hips. This is comparable to previously published data from 1990–97 (Danielsson 2000). Numbers in parentheses denote the percentage of girls in each group.
Mentions: From April 2002 through December 2007, there were 22,517 live births at our hospital and 332 children were referred for examination at our clinic. The incidence of referral was 15/1,000 live births (Figure 3). Of all the children referred, 241 (73%) were girls. 111 children (91 of whom were girls) were treated with the von Rosen splint for 12 weeks. 47 children (40 girls) were treated for 6 weeks. 173 of those referred (110 girls) had bilaterally stable hips. Of the 111 cases with dislocation, 38 (34%) were bilateral, 16 (14%) had an unstable contralateral hip, and 57 (51%) had a stable contralateral hip.

Bottom Line: Screening and early treatment of neonatal instability of the hip (NIH) reduces the incidence of DDH.Even in children who are diagnosed and treated perinatally, radiographic differences in acetabular shape remain at 1 year.To determine whether this is of clinical importance, longer follow-up will be required.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics , Malmö, Skåne University Hospital , Sweden.

ABSTRACT

Background and purpose: As much as one-third of all total hip arthroplasties in patients younger than 60 years may be a consequence of developmental dysplasia of the hip (DDH). Screening and early treatment of neonatal instability of the hip (NIH) reduces the incidence of DDH. We examined the radiographic outcome at 1 year in children undergoing early treatment for NIH.

Subjects and methods: All children born in Malmö undergo neonatal screening for NIH, and any child with suspicion of instability is referred to our clinic. We reviewed the 1-year radiographs for infants who were referred from April 2002 through December 2007. Measurements of the acetabular index at 1 year were compared between neonatally dislocated, unstable, and stable hips.

Results: The incidence of NIH was 7 per 1,000 live births. The referral rate was 15 per 1,000. 82% of those treated were girls. The mean acetabular index was higher in dislocated hips (25.3, 95% CI: 24.6-26.0) than in neonatally stable hips (22.7, 95% CI: 22.3-23.2). Girls had a higher mean acetabular index than boys and left hips had a higher mean acetabular index than right hips, which is in accordance with previous findings.

Interpretation: Even in children who are diagnosed and treated perinatally, radiographic differences in acetabular shape remain at 1 year. To determine whether this is of clinical importance, longer follow-up will be required.

Show MeSH
Related in: MedlinePlus