Risk factors of developmental dysplasia of the hip in a single clinical center

Abstract

Developmental dysplasia of the hip (DDH) is the main cause of early-onset hip osteoarthritis in adulthood. Early screening of DDH is the key to avoiding these severe complications. This study aimed to assure the risk factors are suitable for screening patients with DDH in our region. We retrospectively analyzed 10,668 patients (21,336 hips) at our hospital. Overall, 204 patients with pathological DDH and 408 patients with normal hips were included in this study. All patients were diagnosed by performing ultrasound examinations according to the Graf technique. The risk factors were assessed based on patients' clinical data. Pearson's chi-square or Fisher's exact tests and multivariate logistic regression analysis were performed for statistical analysis. A total of 204 patients were diagnosed with pathologic DDH and were treated with the Pavlik harness. Among these, 184 patients were female. There were 73 cases of first birth, 13 had oligohydramnios, 13 had foot deformity, 31 had breech delivery, 6 had congenital muscular torticollis. Female sex, vaginal delivery, breech presentation, oligohydramnios and foot deformity were identified as the risk factors for DDH. The risk factors of DDH in our clinical center were confirmed in our clinical center, this can supply the screening advice for the doctors.

Figure 1

Schematic diagram showing the study design. DDH, developmental dysplasia of the hip.

Figure 2

Graf technique for classifying different types of developmental dysplasia of the hip. A shows the Graf type technique for a 2-month-old female infant. B shows the Graf type IIb technique for a 3-month-old female infant. C shows the Graf type IIc technique for a 2-month-old female infant. D shows the Graf type D technique for a 3-month-old female infant. E shows the Graf type III technique for a 3-month-old female infant. F shows Graf type IV technique for a 3-month-old female infant.