Clicky hip alone is not a true risk factor for developmental dysplasia of the hip

The Bone & Joint Journal
K NieR W Paton

Abstract

A clicky hip is a common referral for clinical and sonographic screening for developmental dysplasia of the hip (DDH). There is controversy regarding whether it represents a true risk factor for pathological DDH. Therefore a 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological DDH. A total of 362 infants from 1997 to 2016 were referred with clicky hips to our 'one-stop' paediatric hip screening clinic. Hips were assessed clinically for instability and by ultrasound imaging using a simplified Graf/Harcke classification. Dislocated or dislocatable hips were classified as Graf Type IV hips. The mean age at presentation was 13.8 weeks (12.8 to 14.7). In all 351 out of 362 children (97.0%) had Graf Type I hips (normal) that required no treatment. Nine children (2.5%) had Graf Type II hips but all resolved to Graf Type I hips on follow-up scans. One child (0.3%) had Graf Type III hip dysplasia and one child (0.3%) had an irreducible hip dislocation. The two pathological hips were associated with unilateral limited hip abduction. Mean referrals increased from 12.9 to 23.3 each year (p = 0.002) from the first decade of the study t...Continue Reading

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Citations

Jun 2, 2018·The Bone & Joint Journal·F S Haddad
Sep 1, 2018·The Bone & Joint Journal·S HumphryP R Williams
Nov 3, 2017·The Bone & Joint Journal·F S Haddad
Nov 3, 2017·The Bone & Joint Journal·A Aarvold, N M P Clarke
Jun 4, 2019·The Bone & Joint Journal·B A MarsonK R Price
Sep 23, 2020·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·Carla Escribano GarcíaSonia Caserío Carbonero

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