Impact of multiple factors on the incidence of developmental dysplasia of the hip: risk assessment tool

Abstract

Abstract Introduction: Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal conditions in children. Not treated DDH leads to disability, gait abnormalities, limb shortening and chronic pain. Our study aims to determine the impact of multiple risk factors on the occurrence of DDH and develop an interactive risk assessment tool.Materials and Methods: We conducted a retrospective cohort study in the Outpatient Clinic for Children of University Hospital. The Graf classification system was used for ultrasonographic universal screening. In total, 3102 infants met the eligibility criteria (n =6204 hip joints). Results: The incidence of DDH was 4.45%. In multivariate analysis, risk factors for DDH were weight (OR = 2.17 (1.41-3.32)), week of delivery (OR = 1.18 (1.00-1.37)), gender (OR = 8.16 (4.86-13.71)), breech delivery presentation (OR = 5.92 (3.37-10.40)), symptoms of DDH (25.28 (8.77-72.83)) and positive family history in siblings (5.74 (2.68-12.31)). Multivariate logistic regression predictive model was used to construct the interactive risk calculator.Conclusion: We confirmed well-known DDH risk factors in the studied population. Our results support the recent hypothesis that preterm infants (37 < week) have lower rate of DDH. The DDH risk calculator was built but needs external validation in prospective study before being used in a clinical setting.Level of Evidence: Retrospective cohort study: Level III