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. 2013 Oct 24;8(10):e79427.
doi: 10.1371/journal.pone.0079427. eCollection 2013.

Incidence and treatment of developmental hip dysplasia in Mongolia: a prospective cohort study

Bayalag Munkhuu  1 , Stefan Essig, Erdenesuvd Renchinnyam, Raoul Schmid, Corina Wilhelm, Julia Bohlius, Battulga Chuluunbaatar, Enkhtur Shonkhuuz, Thomas Baumann
Affiliations

Incidence and treatment of developmental hip dysplasia in Mongolia: a prospective cohort study

Bayalag Munkhuu et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(1). doi:10.1371/annotation/3208b134-74de-4884-bd5a-0eb2e6c878ec

Abstract

Background: In Mongolia, adequate early diagnosis and treatment of developmental hip dysplasia (DDH) have been unavailable and its incidence was unknown. We determined the incidence of ultrasonographic DDH in newborns and established adequate procedures for diagnosis and treatment of DDH at the largest maternity hospital in Ulaanbaatar, Mongolia.

Methodology/principal findings: During one year (Sept 2010 - Aug 2011) we assessed the hips newborns using ultrasound and Graf's classification of DDH. 8,356 newborns were screened; median age at screening was 1 day. We identified 14,873 Type 1 (89.0%), 1715 Type 2a (10.3%), 36 Type 2c (0.2%), 70 Type D (0.4%), 14 Type 3 (0.08%), and 4 Type 4 hips (0.02%). Children with Type 1 hips (normal) were discharged. Children with Type 2a hips (physiologically immature) received follow-up ultrasounds at monthly intervals. Children with Type 2c to 4 (DDH; deformed or misaligned hip joint) hips were treated with a Tubingen hip flexion splint and also followed up. The hip abnormalities resolved to mature hips in all children who were followed up. There was no evidence for severe treatment related complications.

Conclusion/significance: This study suggests that the incidence of DDH in Mongolian neonates is comparable to that in neonates in Europe. Early ultrasound-based assessment and splinting treatment of DDH led to mature hips in all children followed up. Procedures are feasible and will be continued.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Development of type 2a hips on person levela.
a If a child had hips with different morphologies, the worse hip counted (N=number of children); b Numbers in brackets: (X/Y) X=control, Y=treat. Abbreviation: FU, Follow-up visit; c 4th FU not visualized (2 children with type 1 hips).
Figure 2
Figure 2. Development of type 2a hips on hip levela.
a Any hip (N=number of hips); b Numbers in brackets: (X/Y) X=control, Y=treat. Abbreviation: FU, Follow-up visit; c 4th FU not visualized (3 children with type 1 hips).
Figure 3
Figure 3. Development of type 2c hips on person levela.
a If a child had hips with different morphologies, the worse hip counted (N=number of children); b Numbers in brackets: (X/Y) X=control, Y=treat. Abbreviation: FU, Follow-up visit; c 4th FU not visualized (1 child with type 1 hips).
Figure 4
Figure 4. Development of type D hips on person levela.
a If a child had hips with different morphologies, the worse hip counted (N=number of children); b Numbers in brackets: (X/Y) X=control, Y=treat. Abbreviation: FU, Follow-up visit.
Figure 5
Figure 5. Traditional swaddling in Mongolia.
The legal guardian of the subject in the photograph has given written informed consent, as outlined in the PLoS consent form, to publication of their photograph.
See this image and copyright information in PMC

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