Using the Graf method of ultrasound examination to classify hip dysplasia in neonates

Ano: 2012 | Volume: 2 | Número: 2

Autores: B. C. P. Jacobino, M. D. Galvão, A. F. Silva, C. C. Castro

Palavras-chave: hip dislocation; ultrasonography; congenital abnormalities; infant; newborn.

Resumo Inglês:

Developmental dysplasia of the hip (DDH) is one of the most common congenital
orthopedic anomalies. Ultrasound examination employing the Graf method is
used to diagnose DDH. We conducted a retrospective cross‑sectional study
of 222 neonatal patients (140 females and 82 males) submitted to ultrasound
examination of the right and left hips between January of 2009 and May of
2011. The mean age was 5.0 days. The patients were grouped by laterality,
mean alpha (α) and beta (β) angles (in degrees), and hip type (as determined
by the Graf classification). The data collected were statistically correlated.
Mean α angle values were higher in males than in females, as well as being
higher for right hips than for left hips (p < 0.001). In contrast, mean β angle
values were lower in males than in females, as well as being lower for right
hips than for left hips (p < 0.001). Type Ia hips (i.e., mature hips) predominated
in both genders and on both sides, having been found in 82.32% of the
examinations of males and in 71.09% of those of females. The right hip was
classified as type Ia in 78.38% of the examinations, and the left hip was
classified as type Ia in 72.07%. Type IIa hips (i.e., immature hips) were found
in 12.8% of the examinations of males and in 20% of those of females. The
right hip was classified as type IIa in 13.96% of the examinations, and the left
hip was classified as type IIa in 20.72%. The remaining hip types were less
common. We emphasize the importance of ultrasound as a standard method
of screening for DDH.