![]() ![]() However currently, there are still doubts about this condition and its incidence, as well as the timing and modalities of follow-up (clinical vs. Therefore, for some patients, it would be necessary to carry out subsequent follow-ups after a negative ultrasound screening. ![]() If this condition were to be confirmed, there would be a group of children for whom current screening programs might not be sufficient. Recently, literature has highlighted the possibility of a “late DDH” diagnosis after a negative initial ultrasound screening in children with breech presentation ( 16– 22). Until now, available literature ( 13– 15) did not recommend (even in children with risk factors, including breech presentation) further follow-up after a negative hip ultrasound examination. According to medical literature, despite the current debate between selective and universal screening ( 8– 10), hip ultrasound is considered the most reliable diagnostic examination for DDH ( 11, 12). The Pavlik harness appears to be the most used brace ( 7). In particular, in cases of instability and dislocation, a dynamic splint is the most commonly used treatment, especially if applied within 4–5 months of life. About conservative management of DDH, depending on the patient's age and the severity of the disease, the dynamic or static splint is actually considered the gold standard treatment. Moreover, early detection and referral of newborns with DDH could allow for conservative intervention, preventing the need for surgery ( 6). Other suggested, but not documented, findings are being the first-born, torticollis, foot abnormalities, oligohydramnios, multiple gestations, and macrosomia ( 3, 4).īecause hip development disorders have the potential to cause long-term disabling complications such as gait abnormalities, muscle hypotrophy, degenerative hip, knee injuries, and chronic pain, the main goal is early diagnosis and treatment ( 5). The most important single risk factor is breech position, followed by the female sex, incorrect lower-extremity swaddling, and a positive family history. Although the exact pathophysiological mechanisms are still unknown, there are several known risk factors for DDH. DDH is a complex and dynamic process that encompasses a broad spectrum of developmental abnormalities of the hip, varying from mild dysplasia to complete hip dislocation ( 2). Considering the small study population and the only clinical follow-up, further studies are needed to clarify the possible late development of this condition.ĭevelopmental dysplasia of the hip (DDH) is one of the most common musculoskeletal disorders of newborns, with incidence estimates of 4.4–23.0/1,000 live births ( 1). Only three patients (5.5%) had a pathological examination, but no x-ray were pathological.Ĭonclusion: Our study has not documented cases of late DDH. The median age of orthopedic follow-up examination was 45 months. The median age of gait onset was 13 months. Results: Fifty-five patients (52.7% female, 52.7% with breech presentation, and 41.8% with a positive family history) met the inclusion criteria. In the case of a pathological objective examination, radiography was performed. 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. 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. Recently, reports of late DDH in populations at risk (breech presentation) and after negative ultrasound examination have emerged in the literature.Īim: The objective of the study was to assess the possible appearance of late DDH in Italian children with risk factors but negative ultrasound screening. Ultrasound has proven to be an effective method for the early diagnosis of this condition. 5Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italyīackground: 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.4Department of Woman and Child Health and Public Health, Medical School, Università Cattolica del Sacro Cuore, Roma, Italy.3Department of Orthopedics, Università Cattolica del Sacro Cuore, Roma, Italy.2Department of Orthopedics, Fondazione Policlinico Universitario A.1Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A.Rosa Morello 1,† Beatrice Bocchi 2,3,† Francesco Mariani 1 Alice Bononi 4 Cristina Giuli 2,3 Nadia Bonfiglio 2,3 Piero Valentini 1 Ilaria Lazzareschi 1 Claudia Rendeli 1 Osvaldo Palmacci 2,‡ Danilo Buonsenso 1,5* ‡ ![]()
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