Screening of Developmental Dysplasia of the Hip in Neonates with Breech Presentation

Abstract

Developmental dysplasia of the hip (DDH) is one of the most common congenital malformations and it is an important cause of childhood disability. The term DDH describes a range of hip abnormalities affecting the newborn in which the femoral head and acetabulum are in improper alignment or grow abnormally, or both. The exact incidence of DDH is difficult to determine because of a discrepancy in definition of the condition, type of examination used and different levels of skills of clinicians. Breech presentation was found to be one of the most important risk factors of DDH. The rate of breech presentation is 16-25% for patients with DDH. DDH is one of the congenital anomalies in newborns that if not diagnosed and treated on time can lead to a severe disability. Clinical diagnostic tests complement ultrasound imaging in allowing diagnosis, classification and monitoring of this condition. Treatment in early detected cases is usually done by Pavlik Harness or abduction splints and lately diagnosed cases are mainly treated surgically. The importance of newborn hip screening has been universally accepted, but there is still no strong evidence regarding the superiority of either universal (screening of all newborns) or selective (screening of high-risk newborns) ultrasonographic newborn hip screening programmes.