DETERMINATION OF ABNORMAL HIP ANGLES IN NEONATES BORN WITH RISK FACTORS FOR DEVELOPMENTAL DYSPLASIA OF HIP (DDH)

Abstract

Developmental Dysplasia of the Hip (DDH) is a disorder in which parents and doctors can treat the hip joint abnormally in a wide range, from a level of mild ace-tabular dysplasia to the complete displacement of the femoral head from the acetabulum. Thus, the identification of neonates with any possible hip angle abnormality in subjects with risk factors is critical to providing early intervention to eliminate complications like altered gait patterns and osteoarthritis in later years. Objective: The objective of this investigation is to measure hip angles in neonates with risk factors associated with DDH and assess the frequency of abnormal hip angles utilizing ultrasonography. Methods: This was a prospective design study performed in the Department of Orthopedics, Khyber Teaching Hospital, from 21st July 20224 till 21st October 2024. In all, 146 neonates with at least one perceived risk factor for DDH were recruited into the study within six months. Hip ultrasound was performed on all the participants to evaluate alpha and beta angles defining the ace-tabular index and femoral head coverage respectively. Results: 146 neonates were enrolled in the study, mean gestational age was 38.5 ± 1.2 weeks, mean birth weight was 3.25 ± 0.45 kg; 91 (62.3%) neonates were female and 55 (37.7%) were male. A total of 292 hips were assessed by ultrasonography and were graded based on the Graf system. Of these, 201 hips (68.8%) were of Type I (normal), 52 hips (17.8%) of Type II (immature), 16 hips (5.4%) of Type III (dysplastic) and 9 hips (3.1%) of Type IV (dislocated). Conclusion: This research encourages risk-based triage and underscores the need for continued awareness amongst clinicians about the need to diagnose and treat at-risk newborns before complications from DDH ensue; although the incidence of DDH in different populations is not the same.