Breech Position, Delivery Route and Congenital Hip Dislocation

Clausen, Ingo; Nielsen, K.

doi:10.3109/00016348809004270

Cited by 27 publications

(13 citation statements)

References 9 publications

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“…The incidence in Scandinavia ranges from 0.9 to 28 [51, 64, 92, 94–102, 104–106, 160]. In the United Kingdom, three studies give a low incidence (0.91 in Birmingham, England [111], 1.55 in Manchester, England [33], and 1.7 in Northern Ireland [118]); most range from 3–6 [107, 109, 112–115, 161, 162], with the highest incidence of 30.3 in Aberdeen, Scotland [108].…”

Section: Resultsmentioning

confidence: 99%

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The Epidemiology and Demographics of Hip Dysplasia

2011

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The etiology of developmental dysplasia of the hip (DDH) is unknown. There are many insights, however, from epidemiologic/demographic information. A systematic medical literature review regarding DDH was performed. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%). The incidence per 1000 live births ranges from 0.06 in Africans in Africa to 76.1 in Native Americans. There is significant variability in incidence within each racial group by geographic location. The incidence of clinical neonatal hip instability at birth ranges from 0.4 in Africans to 61.7 in Polish Caucasians. Predictors of DDH are breech presentation, positive family history, and gender (female). Children born premature, with low birth weights, or to multifetal pregnancies are somewhat protected from DDH. Certain HLA A, B, and D types demonstrate an increase in DDH. Chromosome 17q21 is strongly associated with DDH. Ligamentous laxity and abnormalities in collagen metabolism, estrogen metabolism, and pregnancy-associated pelvic instability are well-described associations with DDH. Many studies demonstrate an increase of DDH in the winter, both in the northern and southern hemispheres. Swaddling is strongly associated with DDH. Amniocentesis, premature labor, and massive radiation exposure may increase the risk of DDH. Associated conditions are congenital muscular torticollis and congenital foot deformities. The opposite hip is frequently abnormal when using rigorous radiographic assessments. The role of acetabular dysplasia and adult hip osteoarthritis is complex. Archeological studies demonstrate that the epidemiology of DDH may be changing.

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Section: Resultsmentioning

confidence: 99%

“…Breech position/presentation increases the incidence of DDH [32, 34, 44, 54, 56, 63, 65, 67, 100–102, 105, 106, 114, 118, 135, 139, 162, 168–171, 191, 225, 226, 229–231, 234–243]. Breech position/presentation in children with DDH ranges from 7.1% [32] to 40% [65].…”

Section: Resultsmentioning

confidence: 99%

The Epidemiology and Demographics of Hip Dysplasia

2011

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“…3 They have also not explored the difference between elective and emergency caesarean section nor used a multivariate analysis on all available data: conflicting results concerning the prevalence of DDH among vaginally delivered compared with caesarean delivered breech babies have been reported,12 16 28 some studies being limited by small numbers.…”

Section: Discussionmentioning

confidence: 99%

Perinatal risk factors for developmental dysplasia of the hip

Chan

McCaul

Cundy

et al. 1997

Archives of Disease in Childhood - Fetal and Neonatal Edition

181

162

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Aims-To identify perinatal risk factors for developmental dysplasia of the hip (DDH) and define the risk for each factor. Methods-In this case control study, using logistic regression analysis, all 1127 cases of isolated DDH live born in South Australia in 1986-93 and notified to the South Australian Birth Defects Register were included; controls comprised 150 130 live births in South Australia during the same period without any notified congenital abnormalities. Results-Breech presentation, oligohydramnios, female sex and primiparity were confirmed as risk factors for DDH. Significant findings were an increased risk for vaginal delivery over caesarean section for breech presentation (as well as an increased risk for emergency section over elective section), high birthweight (>4000 g), postmaturity and older maternal age; multiple births and preterm births had a reduced risk. There was no increased risk for caesarean section in the absence of breech presentation. For breech presentation, the risk of DDH was estimated to be at least 2.7% for girls and 0.8% for boys; a combination of factors increased the risk. Conclusions-It is suggested that the risk factors identified be used as indications for repeat screening at 6 weeks of age and whenever possible in infancy. Other indications are family history and associated abnormalities. (Arch Dis Child 1997;76:F94-F100)

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“…According to research by Clausen and Nielsen, the breech position carries the risk of dislocation and dysplasia with a rate of 13.3 % [16]. This study addressed the time of delivery, but with incidence of 86.6 % in the first and 93.3 % in the second group on-time delivery dates; there was no statistical significance for further relation of date of birth and eventual development of avascular necrosis.…”

Section: Resultsmentioning

confidence: 80%

Operative treatment and avascular necrosis of the hip development disorder

Gavrankapetanović

Hadžimehmedagić

Papović

et al. 2014

International Orthopaedics (SICOT)

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Purpose The purpose of this research was (1) to evaluate the consequences of an operative treatment of hip developmental disorder in children, (2) to evaluate the significance of hip vascular supply in children through indirect radiological signs, such as morphological changes on femoral head, and to classify them with standard classification methods, and (3) to analyse the research results and make a recommendation for the following treatment dilemma: when is the optimal time for an operative treatment of a hip development disorder? Methods The research is a retrospective and observational analysis based on the classification of indirect radiological signs of local vascular disorder by the Bucholz-Ogden's scale. Materials used for this research are medical records of treated patients at the Clinic for Orthopaedics and Traumatology of the Sarajevo University Clinical Centre. Using a random selection, two groups of 30 patients with hip development disorder were formed. The first group was comprised of patients aged six to 18 months and the second group of patients aged 18-60 months. The medical records used for this research included all necessary anamnestic details and postoperative state treatments with clinical findings and regular radiological check-up findings that include the presence or absence of the ossification nucleus as well as its position. All patients underwent surgery with the same operative technique. Data analysis points include the state at the beginning of the treatment, the postoperative state, the state at discharge as well as control findings that followed the development of the proximal femoral part up to 72 months on average. The analysis covered data such as age, sex, family anamnestic data, clinical findings and radiological findings regarding the femoral head morphology (appearance, size, shape, position and indirect signs showing lack of vascular supply). In addition, data analysis included the types of any previous conservative or operative treatments, the duration of previous conservative treatments and repeated hospitalization. Results In group 1, 86.6 % were female patients and 80 % in group 2. Family history was positive in 15.6 % in group 1 and 13.3 % in group 2. A total of 51.6 % of all patients started walking on time, while the rest had problems with verticalization. Of all patients, 47 % did not undergo any kind of prior treatment. Only 62.2 % of group 1 patients had ossification nucleus present, while the entire group 2 had it present. Results showed that 24.32 % of group 1 patients had none or minimal signs of avascular necrosis (AVN) while 39.47 % of group 2 had none or minimal signs of AVN; 60.52 % of group 2 patients had signs of AVN. Conclusion The results of this study show that the performance of a surgical treatment during the age between 12 and 20 months is burdened by the highest percentage of avascular necrosis. Even though AVN can be noticed in other age groups, according to the results of our research, it seems that vascular supply of the hip is the mos...

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Breech Position, Delivery Route and Congenital Hip Dislocation

Cited by 27 publications

References 9 publications

The Epidemiology and Demographics of Hip Dysplasia

The Epidemiology and Demographics of Hip Dysplasia

Perinatal risk factors for developmental dysplasia of the hip

Operative treatment and avascular necrosis of the hip development disorder

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