Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population.

PURPOSE

This study evaluated the effectiveness of integrating Graf method into the universal neonatal screening program for detecting developmental dysplasia of the hip (DDH) in Taiwanese population.

METHODS

A total of 4,667 neonates screened between May 2014 and November 2019 were enrolled in this study. Hip ultrasound scans were performed three days after birth, and hips were classified based on their morphology and stability. The incidence rates of early diagnosis, late diagnosis, and surgical interventions for DDH were assessed. Risk factors and treatment measures for DDH were documented.

RESULTS

During the initial examination, 95.95% of hips were classified as Graf type I, while a small proportion were classified as types IIa, IIc (stable/unstable), or III. By the second examination at 4 weeks, all type IIa hips had matured to type I. A total of 35 hips (0.37%) were diagnosed with DDH and treated with a Pavlik harness before 12 weeks, resulting in an early diagnosis rate of 0.37%, with no cases of late diagnosis reported. The incidence of DDH-related surgeries was 0.04%. Multivariable logistic regression identified female sex (OR = 2.41, 95% CI: 1.05-5.52, p = 0.038) and breech presentation (OR = 6.54, 95% CI: 2.22-19.32, p < 0.001) as significant risk factors for DDH.

CONCLUSION

Universal neonatal ultrasound screening using the Graf method is simple and beneficial in the early detection and intervention of DDH. Additionally, it significantly reduces the rates of late diagnosis and the need for surgical intervention.