DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?

L V Barr; A Rehm

doi:10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

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General Orthopaedics

DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?

British Orthopaedic Specialists Association (BOSA)

L V Barr
A Rehm

DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?

Barr LV, Rehm A. DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?. Orthop Procs. 2012;94-B(SUPP_XIII):2-2. doi:10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

Barr, L V, and A Rehm. “DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?.” Orthopaedic Proceedings, vol. 94-B, no. SUPP_XIII, 2012, pp. 2-2., https://doi.org/10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

Barr, L. V., & Rehm, A. (2012). DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?. Orthopaedic Proceedings, 94-B(SUPP_XIII), 2-2. https://doi.org/10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

Barr, L. V. and Rehm, A. (2012) “DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?.” Orthopaedic Proceedings, 94-B(SUPP_XIII), pp. 2-2. Available at: https://doi.org/10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

Barr, L V, and A Rehm. “DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?.” Orthopaedic Proceedings 94-B, no. SUPP_XIII (2012): 2-2. https://doi.org/10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

Barr LV, Rehm A. DEVELOPMENTAL DYSPLASIA OF THE HIP IN TWINS AND MULTIPLE BIRTHS: ARE THEY AT INCREASED RISK, AND SHOULD THEY HAVE UNIVERSAL NEONATAL ULTRASOUND SCANS?. Orthop Procs. 2012 Apr 1;94-B(SUPP_XIII):2-2. https://doi.org/10.1302/1358-992X.94BSUPP_XIII.BOSA2010-002

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Abstract

The purposes of this study were to investigate whether twins and multiple births have a higher incidence of Developmental Dysplasia of the Hip (DDH), and whether universal ultrasound scanning would be beneficial in this population.

Methods

Records of all twin and multiple births between 1st January 2004 and 31st December 2008 at Addenbrooke's Hospital were obtained. Information regarding sex, gestation, birth weight, DDH risk factors, results of the neonatal hip examination and of any ultrasound scans were analysed. The incidence of DDH in singletons born during the same period was calculated from birth records and the DDH database.

Results

Of the 990 twin and multiple births, 267 had ultrasound scans. Of those scanned, over 92% had a normal (bilateral Graf I) scan initially. Within the study cohort there was one case of DDH diagnosed on ultrasound and successfully treated with Pavlik harness. There were two cases of late presenting DDH, one at 8 months and one at 14 months old. Both had no risk factors, a normal neonatal examination and consequently had not had an ultrasound scan.

Conclusion

In our study, twins did not have a significantly higher incidence of DDH compared to singletons. However, ultrasound screening of twins would have detected the two late presenting cases of DDH earlier. It remains to be seen whether universal scanning would be cost-effective.