Clinical Profile and Clinico-Radiological Correlation of Developmental Dysplasia of Hip in Neonates: A Case Control Study

Clinical Profile and Clinico-Radiological Correlation of Developmental Dysplasia of Hip in Neonates

Abstract

Background: Developmental dysplasia of hip is one of the common birth defects and affects 1-2% newborns. Early detection and timely management is necessary to prevent avascular necrosis of femoral head, premature arthritis and hip replacement. Subjects and Methods: The study aims to identify the risk factors and clinic-radiological correlation for diagnosing developmental dysplasia of hip in newborns. An observational case-control study was carried out in a tertiary care super-specialty hospital and 2403 newborns less than 72 hours of life were enrolled over a period of 18 months. Newborns were classified as case, who have DDH and as control, who does not have DDH. Physical examination were conducted and ultrasonography and radiography were done.  Results: The incidence of the DDH in new-born was found to be 9.5 per 1000 new-born. The sensitivity of the clinical examination was found to be 97% and specificity was 13.68%. Our study identifies following as independent risk factors for DDH: girl sex (86.96%), primigravida (60.87%), multiple births (52.17%), breech presentation (82.61%) and gestation more than 37 weeks (77.07%). Keeping USG as a gold standard to diagnose DDH, Barlow’s and Ortolani’s tests could serve as an excellent tool to screen DDH. Female newborns, Primigravida, multiple births, breech delivery, and gestation of more than 37 weeks were found to be statistically significant risk factors for the development of DDH. There was no significant association found between the age of the mother and mode of delivery on the chance of developing DDH in newborns. Conclusion: Early screening of DDH is necessary to prevent long term morbidity, especially in newborns with high risk factors.