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Nascer e Crescer

Print version ISSN 0872-0754


GOMES, Susana et al. Developmental dysplasia of the hip: six years of ultrasound screening in risk children. Nascer e Crescer [online]. 2012, vol.21, n.4, pp.226-229. ISSN 0872-0754.

Introduction: Developmental dysplasia of the hip (DDH) is a congenital condition that is screened based on systematic physical examination. Submission to image exams and its optimal occasion remains controversial. The screening protocol used in our hospital includes physical examination to all neonates, complemented by hip ultrasound (US) if any risk factor for the development of DDH is detected: clinical suspicion, family history, breech presentation, multiple gestation, lower limb deformity or oligoamnius. In case of suspected anomaly, US is repeated one month after and hip radiography is performed at five months of age. Aims: Evaluate the adequacy and value of the screening protocol for DDH used in our hospital and to identify the diagnostic implications of including high risk children. Methods: Descriptive retrospective analysis of clinical data of children admitted to the protocol from 2001 to 2006. Results: One hundred and two of the 668 children submitted to the protocol were considered to have US DDH criteria (incidence 11.7/1000 live births). Barlow and Ortolani signals, when used together, had a specificity of 99.8% and a sensibility of 22.5% to the diagnosis, but 40 of the screened had n clinical signs. In 29 cases hip abduction corrective devices were used and there was no need for surgical correction. There were no complications of treatment; 2.7% of the children abandoned the protocol. Conclusion: The inclusion of children with risk factors allowed the detection of DDH without clinical findings and their early treatment. The favourable outcome and the inexistence of complications allow us to conclude that the protocol is effective.

Keywords : Congenital hip dysplasia; risk factors; screening; ultrasound.

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