Öz
Özet
Amaç: Bu çalışmanın amacı; Gelişimsel kalça displazisi (GKD) nedeniyle sonografik tarama sırasında Tip2a kalça tespit edilen 4-8 haftalık çocuk, kalçanın sonografik bozulması ile ilişkili risk faktörlerini belirlemektir.
Gereç ve Yöntemler: Ocak 2018-Aralık 2020 arasında, tek bir merkezde GKD taraması nedeniyle başvuran 4-8 haftalık 1746 çocuğun, 3492 kalçası retrospektif olarak incelendi. Hastanemize başvuran ve sonografik incelemesinde Tip2a tespit edilen ve 4 hafta sonraki kontrolüne gelerek sonografik inceleme yapılan 195’i (%70) kadın, 84’ü (%30) erkek toplam 279 çocuğun 360 kalçası çalışmaya alındı.
Bulgular: Olguların 91’i (%32.6) sağ, 107’si (%38.3) sol, 81’i (%29) bilateral olmak üzere incelenen 360 kalçanın sonraki sonografik incelemelerinde, %85’inin (n=306) kendiliğinden düzeldiği ve %15’inin (n=54) sonografik olarak kötüleştiği görülmüştür. Makat geliş ve nörolojik hastalık (p=0,000) ile sonografik bozulma arasında ise istatistiksel olarak anlamlı bir ilişki olduğu tespit edilmiştir (sırasıyla; p=0,002, p=0,000). Sonografik bozulma riski makat gelişi olanlarda olmayanlara göre 5,3 kat, nörolojik hastalığı olanlarda olmayanlara göre 9,6 kat daha yüksek bulunmuştur.
Sonuç: GKD nedeniyle yapılan sonografik tarama sırasında Graf Tip2a kalça tespit edilen çocuklarda, nörolojik hastalık ve makat geliş varlığı sonografik kötüleşme için bağımsız risk faktörüdür. Bu çocukların takiplerinde dikkatli olunması ve ailelerin bilgilendirilmesi önemlidir.
Anahtar Kelimeler
Gelişmsel Kalça Displazisi (gkd) Sonografik tarama Graf Tip 2a
Destekleyen Kurum
yok
Proje Numarası
yok
Teşekkür
yok
Kaynakça
- 1. Omeroğlu H. Use of ultrasonography in developmental dysplasia of the hip. J Child Orthop. 2014 Mar;8(2):105-13.
- 2. Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986 Dec;(213):20-33.
- 3. Copuroglu C, Ozcan M, Aykac B, Tuncer B, Saridogan K. Reliability of ultrasonographic measurements in suspected patients of developmental dysplasia of the hip and correlation with the acetabular index. Indian J Orthop. 2011;45(6):553-557.
- 4. Graf R. New possibilities for the diagnosis of congenital hip joint dislocation by ultrasonography. J Pediatr Orthop. 1983 Jul;3(3):354-9.
- 5. Graf R. (2006) Hip sonography. Diagnosis and management of infant hip dysplasia. Springer, Berlin
- 6. Klisic PJ. Congenital dislocation of the hip--a misleading term: brief report. J Bone Joint Surg Br. 1989 Jan;71(1):136.
- 7. Dorn U, Neumann D. Ultrasound for screening developmental dysplasia of the hip: a European perspective. Curr Opin Pediatr. 2005 Feb;17(1):30-3.
- 8. Tomà P, Valle M, Rossi U, Brunenghi GM. Paediatric hip--ultrasound screening for developmental dysplasia of the hip: a review. Eur J Ultrasound. 2001 Oct;14(1):45-55.
- 9. Delaney LR, Karmazyn B. Developmental dysplasia of the hip: background and the utility of ultrasound. Semin Ultrasound CT MR. 2011 Apr;32(2):151-6.
- 10. Sewell MD, Eastwood DM. Screening and treatment in developmental dysplasia of the hip-where do we go from here? Int Orthop. 2011 Sep;35(9):1359-67. doi: 10.1007/s00264-011-1257-z. Epub 2011 May 7. PMID: 21553044; PMCID: PMC3167447.
- 11. Kosar P, Ergun E, Gökharman FD, Turgut AT, Kosar U. Follow-up sonographic results for Graf type 2A hips: association with risk factors for developmental dysplasia of the hip and instability. J Ultrasound Med. 2011 May;30(5):677-83
- 12. Gemici A. A. , Arslan G. , Yırgın İ. K. GRAF METODUNA GÖRE TİP 2A KALÇALARDA TAKİP BULGULARIMIZ VE ULTRASONOGRAFİK İLERLEME GÖSTEREN OLGULARDA RİSK FAKTÖRLERİ. Bozok Tıp Dergisi. 2013; 3(3): 11-18.
- 13. Bilgili F, Sağlam Y, Göksan SB, Hürmeydan ÖM, Birişik F, Demirel M. Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making. Balkan Med J. 2018 Nov 15;35(6):427-430.
- 14. Holen KJ, Tegnander A, Terjesen T, et al. Ultrasonographic evaluation of breech presentation as a risk factor for hip dysplasia. Acta Paediatr 1996; 85:225–229.
- 15. Imrie M, Scott V, Stearns P, Bastrom T, Mubarak SJ. Is ultrasound screening for DDH in babies born breech sufficient? J Child Orthop. 2010;4(1):3-8.
- 16. Chan A, McCaul KA, Cundy PJ, Haan EA, ByronScott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 1997;76(2):94–100.
- 17. Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011 Oct 10;2011:238607.
- 18. Swarup I, Penny CL, Dodwell ER. Developmental dysplasia of the hip: an update on diagnosis and management from birth to 6 months. Curr Opin Pediatr. 2018 Feb;30(1):84-92.
- 19. Lange AE, Lange J, Ittermann T, Napp M, Krueger PC, Bahlmann H, Kasch R, Heckmann M. Population-based study of the incidence of congenital hip dysplasia in preterm infants from the Survey of Neonates in Pomerania (SNiP). BMC Pediatr. 2017 Mar 16;17(1):78.
- 20. Orak MM, Onay T, Gümüştaş SA, Gürsoy T, Muratlí HH. Is prematurity a risk factor for developmental dysplasia of the hip? : a prospective study. Bone Joint J. 2015 May;97-B(5):716-20.
- 21. Stevenson DA, Mineau G, Kerber RA, Viskochil DH, Schaefer C, Roach JW. Familial predisposition to developmental dysplasia of the hip. J Pediatr Orthop. 2009 Jul-Aug;29(5):463-6.
- 22. Woodacre T, Ball T, Cox P. Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors. J Child Orthop. 2016 Dec;10(6):633-642
Öz
Abstract
Objective: The aim of this study is to determine the risk factors associated with sonographic deterioration of the hip in children aged 4-8 weeks with Type 2a hip detected during sonographic screen due to developmental dysplasia of the hip (DDH).
Material-Methods: 3492 hips of 1746 children aged 4-8 weeks who applied for DDH screening in a single center between January 2018 and December 2020 were retrospectively examined. A total of 360 hips of 279 children, of which 195 (70%) were women and of which 84 were men (30%), who applied to our hospital and diagnosed with Type 2a in the sonographic examination and were followed up 4 weeks later and underwent sonographic examinations, were included in this study.
Results: In the subsequent sonographic examinations of 360 hips, of which 91 (32.6%) were right, of which 107 (38.3%) were left, of which 81 (29%) were bilateral hips of cases, 85% of the hips (n=306) recovered spontaneously and 15% (n=54) deteriorated sonographically. On the other hand, it was seen that there was a statistically significant correlation between breech presentation and neurological disease (p=0.000) and sonographic deterioration (p=0.002, p=0.000, respectively). The risk of sonographic deterioration was found to be 5.3 times higher in those with breech presentation than in those without, and 9.6 times higher in those with neurological disease than in those without.
Conclusion: Neurologic disease and breech presentation are independent factor for sonographic deterioration in children with Graf Type 2a hip detected during sonographic screening for DDH. It is important to be careful in the follow-up of these children and to inform the families.
Anahtar Kelimeler
Developmental Dysplasia of the Hip (DDH) Sonographic screening Graf Type 2a
Proje Numarası
yok
Kaynakça
- 1. Omeroğlu H. Use of ultrasonography in developmental dysplasia of the hip. J Child Orthop. 2014 Mar;8(2):105-13.
- 2. Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986 Dec;(213):20-33.
- 3. Copuroglu C, Ozcan M, Aykac B, Tuncer B, Saridogan K. Reliability of ultrasonographic measurements in suspected patients of developmental dysplasia of the hip and correlation with the acetabular index. Indian J Orthop. 2011;45(6):553-557.
- 4. Graf R. New possibilities for the diagnosis of congenital hip joint dislocation by ultrasonography. J Pediatr Orthop. 1983 Jul;3(3):354-9.
- 5. Graf R. (2006) Hip sonography. Diagnosis and management of infant hip dysplasia. Springer, Berlin
- 6. Klisic PJ. Congenital dislocation of the hip--a misleading term: brief report. J Bone Joint Surg Br. 1989 Jan;71(1):136.
- 7. Dorn U, Neumann D. Ultrasound for screening developmental dysplasia of the hip: a European perspective. Curr Opin Pediatr. 2005 Feb;17(1):30-3.
- 8. Tomà P, Valle M, Rossi U, Brunenghi GM. Paediatric hip--ultrasound screening for developmental dysplasia of the hip: a review. Eur J Ultrasound. 2001 Oct;14(1):45-55.
- 9. Delaney LR, Karmazyn B. Developmental dysplasia of the hip: background and the utility of ultrasound. Semin Ultrasound CT MR. 2011 Apr;32(2):151-6.
- 10. Sewell MD, Eastwood DM. Screening and treatment in developmental dysplasia of the hip-where do we go from here? Int Orthop. 2011 Sep;35(9):1359-67. doi: 10.1007/s00264-011-1257-z. Epub 2011 May 7. PMID: 21553044; PMCID: PMC3167447.
- 11. Kosar P, Ergun E, Gökharman FD, Turgut AT, Kosar U. Follow-up sonographic results for Graf type 2A hips: association with risk factors for developmental dysplasia of the hip and instability. J Ultrasound Med. 2011 May;30(5):677-83
- 12. Gemici A. A. , Arslan G. , Yırgın İ. K. GRAF METODUNA GÖRE TİP 2A KALÇALARDA TAKİP BULGULARIMIZ VE ULTRASONOGRAFİK İLERLEME GÖSTEREN OLGULARDA RİSK FAKTÖRLERİ. Bozok Tıp Dergisi. 2013; 3(3): 11-18.
- 13. Bilgili F, Sağlam Y, Göksan SB, Hürmeydan ÖM, Birişik F, Demirel M. Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making. Balkan Med J. 2018 Nov 15;35(6):427-430.
- 14. Holen KJ, Tegnander A, Terjesen T, et al. Ultrasonographic evaluation of breech presentation as a risk factor for hip dysplasia. Acta Paediatr 1996; 85:225–229.
- 15. Imrie M, Scott V, Stearns P, Bastrom T, Mubarak SJ. Is ultrasound screening for DDH in babies born breech sufficient? J Child Orthop. 2010;4(1):3-8.
- 16. Chan A, McCaul KA, Cundy PJ, Haan EA, ByronScott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 1997;76(2):94–100.
- 17. Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011 Oct 10;2011:238607.
- 18. Swarup I, Penny CL, Dodwell ER. Developmental dysplasia of the hip: an update on diagnosis and management from birth to 6 months. Curr Opin Pediatr. 2018 Feb;30(1):84-92.
- 19. Lange AE, Lange J, Ittermann T, Napp M, Krueger PC, Bahlmann H, Kasch R, Heckmann M. Population-based study of the incidence of congenital hip dysplasia in preterm infants from the Survey of Neonates in Pomerania (SNiP). BMC Pediatr. 2017 Mar 16;17(1):78.
- 20. Orak MM, Onay T, Gümüştaş SA, Gürsoy T, Muratlí HH. Is prematurity a risk factor for developmental dysplasia of the hip? : a prospective study. Bone Joint J. 2015 May;97-B(5):716-20.
- 21. Stevenson DA, Mineau G, Kerber RA, Viskochil DH, Schaefer C, Roach JW. Familial predisposition to developmental dysplasia of the hip. J Pediatr Orthop. 2009 Jul-Aug;29(5):463-6.
- 22. Woodacre T, Ball T, Cox P. Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors. J Child Orthop. 2016 Dec;10(6):633-642
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | yok |
| Yayımlanma Tarihi | 21 Mart 2022 |
| Gönderilme Tarihi | 24 Eylül 2021 |
| Kabul Tarihi | 8 Kasım 2021 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 17 Sayı: 1 |
