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Ultrasound examination of neonatal hip: correlation of twin pregnancy and congenital dysplasia

Published online by Cambridge University Press:  21 February 2012

O Rühmann*
Affiliation:
Orthopaedic Department, Hannover Medical School, Hannover, Germany. ruehmann@annastift,de
D Lazović
Affiliation:
Orthopaedic Department, Hannover Medical School, Hannover, Germany.
P Bouklas
Affiliation:
Department of Surgery, Versmold Hospital, Versmold, Germany.
S Schmolke
Affiliation:
Orthopaedic Department, Hannover Medical School, Hannover, Germany.
CH Flamme
Affiliation:
Orthopaedic Department, Hannover Medical School, Hannover, Germany.
*
*Correspondence: Dr Oliver Rühmann, Orthopaedic Department, Hannover Medical School, Heimchenstr. 1–7, D-30625 Hannover, Germany. Tel: + + 511 5354340; Fax: + + 511 5354682

Abstract

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Twin pregnancy is considered to be a risk factor for congenital dysplasia of the hip. From 1987 until 1996, the hips of 4476 (2260 male, 2216 female) newborn babies were examined by ultrasound according to Graf's technique and classification in our hospital. In this study, we compare the results of twins and singletons for this risk factor. Of the newborns, 97 (2.2%) were twins (40 male, 57 female); 39 pairs of twins (10 male/male, 19 female/female, 10 male/female) and 19 individual twins (6 male, 13 female) were investigated. Hips of typeIa, Ib and IIa (α ≥ 55°) are not pathologic; hips of typeIIa (α < 55°) need an early control examination; and hips of typeIIc, D, IIIa, IIIb and IV require therapy. TypesIa, Ib, and IIa (α ≥ 55°) were found in 4207 (94.0%) of all newborns, in 4112 (93.9%) of the singletons, and in 95 (97.9%) of the twins. Early control examination and/or therapy (indicated for typesIIa (α < 55°), IIc, D, IIIa, IIIb, and IV) were necessary in 269 (6.0%) of all cases, in 267 (6.1%) of singletons and two (2.1%) of twins. Twins with additional factors such as breech position birth, hip dysplasia in the family or premature birth did not show the types of hip IIa (α < 55°), IIc, D, IIIa, IIIb, IV. We did find these hips in two (3.5%) of the female twins, but not at all in the male twins. Statistically, twins with or without other risk factors that are known before birth did not show significantly more of type hip IIa (α < 55°), IIc, D, IIIa, IIIb, IV (P > 0.05). Twin Research (2000) 3, 7–11.

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Copyright © Cambridge University Press 2000