Affiliation:
1. General and Orthopaedic Hospital Stolzalpe, 8852, Stolzalpe Austria
2. Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz Austria
Abstract
Purpose/Background/IntroductionThe aim of this study was to retrospectively evaluate the impact of neonatal sonographic hip screening using Graf’s method for the management and outcome of orthopaedic treatment of decentered hip joints with developmental dysplasia of the hip (DDH), using three decades (1978–2007) of clinical information compiled in a medical database.MethodsThree representative cohorts of consecutive cases of decentered hip joints were selected according to different search criteria and inclusion and exclusion parameters: (1) cohort 1 (1978–1982; n = 80), without sonographic screening; (2) cohort 2.1 (1994–1996; n = 91), with nationwide established general sonographic screening according to the Graf-method; (3) cohort 2.2 (2003–2005; n = 91), with sonographic screening including referred cases for open reduction from non-screened populations. These three cohorts were compared for the following parameters: age at initial treatment, successful closed reduction, necessary overhead traction, necessary adductor-tenotomy, rate of open reduction, rate of avascular necrosis (AVN) and rate of secondary acetabuloplasty.ResultsThe age at initial treatment was reduced from 5.5 months in the first cohort to 2 months in the two subsequent two cohorts and the rate of successful closed reduction increased from 88.7 to 98.9 and 95.6%, respectively. There was a statistically significant improvement in six out of seven parameters with sonographic hip screening; only the rate of secondary acetabuloplasty did not improve significantly.ConclusionCompared to the era before the institution of a sonographic hip screening programme according to the Graf-method in Austria in 1992, ultrasound screening based-treatment of decentered hip joints has become safer, shorter and simpler: “safer” means lower rate of AVN, “shorter” means less treatment time due to earlier onset and “simpler” means that the devices are now less invasive and highly standardized.
Subject
Orthopedics and Sports Medicine,Pediatrics, Perinatology and Child Health
Cited by
43 articles.
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