ULTRASOUND SCREENING OF THE HIP IN INFANTS

Abstract

Introduction and Objectives: This study reviews the results of osteoarticular ultrasound of the hip in infants using the Graf method between 1992 and 2002 for the diagnosis and treatment of congenital hip dysplasia (CHD) and congenital hip dislocation in the province of Santa Cruz de Tenerife, Canary Islands, Spain. The objective of this study is to evaluate the impact of early diagnosis and treatment of infant hip pathologies related to CHD using a non-invasive, reproducible, and relatively easy-to-use method of clinical evaluation.

Materials and Methods: Between 1992 and 2002, 5,760 (18%) of a total 32,000 newborns in our province received an ultrasound examination using the Graf technique due to the presence of one or more risk factors. Graf methods and ultrasonographic criteria were used to conduct a systematic study with static ultrasonograms, dynamic studies, and/or stress studies of the hips. During the 10-year period, only 4 hips required surgical intervention after one year of age when orthopaedic treatment was not an option. This represents a significant reduction in the rate of surgery due to earlier treatment after ultrasonographic diagnosis.

Results: Risk factors associated with the appearance of congenital hip deformities diagnosed by ultrasound in the infant population of Santa Cruz de Tenerife, in order of frequency, were as follows: female newborn, first pregnancy, first birth (36%), lax hip (30%), asymmetry (25%), positive Ortolani hip clunk (15%), family history (15%), reduced abduction (6%), associated osteoarticular pathology (5%), prematurity (3%), and others. Ultrasound made it possible to initiate early treatment and control. The wide pillow (including the Frejka abduction pillow) was used in 31.63% of cases, Pavlik harness in 10.87%, a DSS splint in one case, and the Kramer extension/repositioning technique requiring hospitalisation was used in 1.92% of cases. Average age to maturity of dysplastic hips (reaching type I) was 4 months.

Discussion and Conclusions: There are no significant differences between the results obtained in our study and those reported in the literature of other populations on the use of ultrasonographic hip screening using the Graf technique.