Risk Factors Assessment of Patients Diagnosed with Developmental Dysplasia of the Hip: Review of 574 Patients - Abstract
Background: Early detection of developmental dysplasia of the hip (DDH) will provide an early conservative management and reduce the chance of surgical intervention. Many risk factors of DDH have been identified (family history, breech presentation, being first child, and oligohydramnious).The aim of the study is to assess the risk factors in patients diagnosed with DDH.
Methods: A retrospective study on DDH patients from January 2007 to December 2013, in two major hospitals. Data was collected from the charts and X-rays were reviewed by pediatric orthopedic staffs.
Results: Out of 574 DDH patients (832 hips) identified in the study, 515 (89.7%) presented to the clinic at age of more than 3 months. The majority of the affected patients were female (479 [83.5%]). Only 253 patients (44.1%) had an identifiable risk factor while 50 patients (19.8%) had more than one risk factor. Among all study subjects, only 5 patients (0.9%) had oligohydramnious during their pregnancy, 54 (9.4%) presented with a history of breech presentation, 86 (15%) were first child to the family, and 165(28.8%) had a positive family history for DDH.
Conclusion: Family history was found to be the most prevalent risk factor of DDH while oligohydramnious was the least. No risk factors were identified in most of the DDH patients, thus we recommend a carful hip examination by pediatrician during the regular follow up. Since most patients were diagnosed late after the age of 3 months, we recommend a national screening program for every newborn in the nursery and pediatricians should be carefully examine and follow them up in the well-baby clinic with vaccinations.