Assessment for late developmental hip dysplasia in a cohort of infants with risk factors and normal hip ultrasound

Rosa Morello; Beatrice Bocchi; Francesco Mariani; Alice Bononi; Cristina Giuli; Nadia Bonfiglio; Piero Valentini; Ilaria Lazzareschi; Claudia Rendeli; Osvaldo Palmacci; Danilo Buonsenso

doi:10.3389/fped.2023.1140349

Assessment for late developmental hip dysplasia in a cohort of infants with risk factors and normal hip ultrasound

Front Pediatr. 2023 Mar 21:11:1140349. doi: 10.3389/fped.2023.1140349. eCollection 2023.

Authors

Rosa Morello¹, Beatrice Bocchi^{2

3}, Francesco Mariani¹, Alice Bononi⁴, Cristina Giuli^{2

3}, Nadia Bonfiglio^{2

3}, Piero Valentini¹, Ilaria Lazzareschi¹, Claudia Rendeli¹, Osvaldo Palmacci², Danilo Buonsenso^{1

5}

Affiliations

¹ Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
² Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
³ Department of Orthopedics, Università Cattolica del Sacro Cuore, Roma, Italy.
⁴ Department of Woman and Child Health and Public Health, Medical School, Università Cattolica del Sacro Cuore, Roma, Italy.
⁵ Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italy.

Abstract

Background: Developmental dysplasia of the hip (DDH) is a known orthopedic pathology of newborns that, if not diagnosed and treated, can lead to debilitating long-term consequences. Ultrasound has proven to be an effective method for the early diagnosis of this condition. Recently, reports of late DDH in populations at risk (breech presentation) and after negative ultrasound examination have emerged in the literature.

Aim: The objective of the study was to assess the possible appearance of late DDH in Italian children with risk factors but negative ultrasound screening.

Materials and methods: We selected patients with risk factors for DDH and a negative hip ultrasound from the medical records of children referred to the Hip Ultrasound Clinic (Rome, Italy) from January 2018 to November 2021. To identify possible cases of late DDH, from February 2022 to July 2022, all patients who met the inclusion criteria were submitted to orthopedic follow-up clinical evaluation. In the case of a pathological objective examination, radiography was performed.

Results: Fifty-five patients (52.7% female, 52.7% with breech presentation, and 41.8% with a positive family history) met the inclusion criteria. The median age of gait onset was 13 months. The median age of orthopedic follow-up examination was 45 months. Only three patients (5.5%) had a pathological examination, but no x-ray were pathological.

Conclusion: Our study has not documented cases of late DDH. Considering the small study population and the only clinical follow-up, further studies are needed to clarify the possible late development of this condition.

Keywords: DDH; Graf technique; breech position; hip ultrasound; late DDH; risk factors.