Current issues in the diagnostics of hip dysplasia in newborns in the regions of the Russian Federation

Abstract

BACKGROUND: Early diagnostics of hip dysplasia in newborns are important medical and social problems because untimely treatment of these children leads to severe irreversible pathological disorders of the hip joint, dysplastic coxarthrosis, and consequently disability. Anamnesis data of patients from the Department of Hip Pathology of H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery show that late diagnoses of the dysplastic pathology of the hip joint are not rare, which does not tend to decrease in number.

AIM: To identify and analyze the causes of the late diagnosis of dysplastic hip joint pathology in newborns in the Russian Federation.

MATERIALS AND METHODS: Statistical data from 64 regions of the Russian Federation were collected and analyzed to study the causes of untimely diagnosis of dysplastic hip joint pathology in newborns.

RESULTS: According to the information received, 3,456,207 children were born in 64 regions of the Russian Federation between 2019 and 2021. Of these children, 108,737 (3.1%) were diagnosed with hip dysplastic pathology of varying severity (acetabular dysplasia, subluxation, and dislocation), and 3,943 cases (3.6%) had untimely diagnosis.

CONCLUSIONS: Late diagnosis is primarily caused by the untimely appearance of patients for ultrasound screening and initial examination by an orthopedist. The secondary reason is the understaffing of medical organizations with specialists–orthopedists and specialists in Doppler ultrasound examination. To reduce the number of cases of late diagnosed or missed dysplastic hip pathologies and improve the quality of orthopedic care for children in the Russian Federation, strengthening health education must be recommended among parents and staff of medical organizations with orthopedic and ultrasound specialists.

Keywords

children / hip joint / dysplasia / diagnostics

References

[1] Marks VO. Diagnostika i lechenie vrozhdennogo vyvikha bedra u detei. Orthopedics, Traumatology. 1934;(3):3–5. (In Russ.)

[2] Маркс В.О. Диагностика и лечение врожденного вывиха бедра у детей // Ортопедия, травматология. 1934. № 3. С. 3–5.

[3] Barta O. Vrozhdennyj vyvih bedra i ego rannee konservativnoe lechenie. Budapest: izdatel’stvo AN Vengrii; 1972. (In Russ.)

[4] Барта О. Врожденный вывих бедра и его раннее консервативное лечение. Будапешт: издательство АН Венгрии, 1972. 215 с.

[5] Mirzoeva II, Goncharova MN, Tihonenkov ES. Operativnoe lechenie vrozhdennogo vyvikha bedra u detei. Leningrad: Meditsina; 1976. (In Russ.)

[6] Мирзоева И.И., Гончарова М.Н., Тихоненков Е.С. Оперативное лечение врожденного вывиха бедра у детей. Ленинград: Медицина, 1976. 232 с.

[7] Kucenok YaB, Rulla EA, Mel’nik VV. Vrozhdennaya displaziya tazobedrennogo sustava. Kiev: Zdorov’ya; 1992. (In Russ.)

[8] Куценок Я.Б., Рулла Э.А., Мельник В.В. Врожденная дисплазия тазобедренного сустава. Врожденный подвывих и вывих бедра. Киев: Здоров’я, 1992. 182 с.

[9] Yamamuro T, Ishida K. Recent advances in the prevention, early diagnosis, and treatment of congenital dislocation of the hip in Japan. Clin Orthop. 1984;(184):34–40.

[10] Yamamuro T., Ishida K. Recent advances in the prevention, early diagnosis, and treatment of congenital dislocation of the hip in Japan // Clin. Orthop. 1984. No. 184. P. 34–40.

[11] Ishida K. Prevention of the development of a typical hip dislocation. Clin Orthop Relat Res. 1977;(126):167–169.

[12] Ishida K. Prevention of the development of the typical dislocation of the hip // Clin. Orthop. Relat. Res. 1977. No. 126. P. 67–69.

[13] Tredwell SJ, Davis L. A prospective study of congenital dislocation of the hip. J Pediatr Orthop.1989;(9):386–390.

[14] Tredwell S.J., Davis L. Prospective study of congenital dislocation of the hip // J. Pediatr. Orthop.1989. Vol. 9. No. 4. P. 386–390.

[15] Volkov MV, Ter-Egiazarov GM, Yukina GP. Vrozhdennyi vyvikh bedra. Moscow: Meditsina; 1972. (In Russ.)

[16] Волков М.В., Тер-Егиазаров Г.М., Юкина Г.П. Врожденный вывих бедра. Москва: Медицина, 1972. 159 с.

[17] Krasnov AI. Mnogoploskostnye deformatsii proksimal’nogo otdela bedrennoi kosti posle konservativnogo lecheniya vrozhdennogo vyvikha bedra u detei (patogenez, klinika, diagnostika, lechenie) [abstract dissertation]. Leningrad; 1990. (In Russ.)

[18] Краснов А.И. Многоплоскостные деформации проксимального отдела бедренной кости после консервативного лечения врожденного вывиха бедра у детей (патогенез, клиника, диагностика, лечение): автореф. дис. ... канд. мед. наук. Ленинград, 1990.

[19] Tihilov RM. Khirurgicheskoe lechenie bol’nykh s degenerativno-distroficheskimi zabolevaniyami i posledstviyami travm tazobedrennogo sustava [abstract dissertation]. Saint Petersburg; 1998. (In Russ.)

[20] Тихилов Р.М. Хирургическое лечение больных с дегенеративно-дистрофическими заболеваниями и последствиями травм тазобедренного сустава: автореф. дис. … д-ра мед. наук. Санкт-Петербург, 1998.

[21] Kamosko MM. Transpozitsiya vertluzhnoi vpadiny pri nestabil’nosti tazobedrennogo sustava displasticheskogo geneza [abstract dissertation]. Saint Petersburg; 2007. (In Russ.)

[22] Камоско М.М. Транспозиция вертлужной впадины при нестабильности тазобедренного сустава диспластического генеза: дис. … д-ра мед. наук. Санкт-Петербург, 2007.

[23] Tonnis D. Surgical treatment of congenital hip dislocation. Clin Orthop Relat Res. 1990;(258):33–40.

[24] Tönnis D. Surgical treatment of congenital dislocation of the hip // Clin. Orthop. Relat. Res. 1990. No. 258. P. 33–40.

[25] Valdisseri L, Campagnaro J, Urso K. The treatment of congenital hip dislocation between the ages of 1 and 3. Chir Organi Mov. 1992;77(3):219–231.

[26] Valdisseri L., Campagnaro J., Urso K. The treatment of congenital hip dislocation between the ages of 1 and 3 // Chir. Organi. Mov. 1992. Vol. 77. No. 3. P. 219–231.

[27] Weinstein S, Mubarak S, Wenger D. Developmental hip dysplasia and dislocation: part I. Instr Course Lect. 2004;53(3):523–530.

[28] Weinstein S., Mubarak S., Wenger D. Developmental hip dysplasia and dislocation: Part I // Instr. Course. Lect. 2004. Vol. 53. No. 3. P. 523–530.

[29] Baskov VE. Ortopedokhirurgicheskoe lechenie detei s displasticheskim marginal’nym vyvikhom bedra [abstract dissertation]. Saint Petersburg; 2009. (In Russ.)

[30] Басков В.Е. Ортопедохирургическое лечение детей с диспластическим маргинальным вывихом бедра: дис. … канд. мед. наук. Санкт-Петербург, 2009.

[31] Gulati V, Eseonu K, Sayani J, et al. Developmental dysplasia of the hip in the newborn: a systematic review. World J Orthop. 2013;4(2):32–41. DOI: 10.5312/wjo.v4.i2.32

[32] Gulati V., Eseonu K., Sayani J., et al. Developmental dysplasia of the hip in the newborn: a systematic review // World J. Orthop. 2013. Vol. 4. No. 2. P. 32–41. DOI: 10.5312/wjo.v4.i2.32

[33] De Pellegrin M, Moharamzadeh D, Fraschini G. Early diagnosis and treatment of DDH: a sonographic approach. Hip Int. 2007;17(S5):15–21.

[34] De Pellegrin M., Moharamzadeh D., Fraschini G. Early diagnosis and treatment of DDH: a sonographic approach // Hip. Int. 2007. Vol. 17. No. S5. P. 15–21.

[35] Tan SHS, Wu CH, Wong KL, et al. Correlations between ultrasonographic and subsequent radiographic findings of developmental dysplasia of the hips. Ultrasonography. 2019;38(4):43–51. DOI: 10.14366/usg.18064

[36] Tan S.H.S., Wu C.H., Wong K.L., et al. Correlations between ultrasonographic and subsequent radiographic findings of developmental dysplasia of the hips // Ultrasonography. 2019. Vol. 38. No. 4. P. 43–51. DOI: 10.14366/usg.18064

[37] Gokharman FD, Aydin S, Fatihoglu E, et al. Optimizing the time for developmental dysplasia of the hip screening: earlier or later? Ultrasound Q. 2019;35(2):130–135. DOI: 10.1097/RUQ.0000000000000348

[38] Gokharman F.D., Aydin S., Fatihoglu E., et al. Optimizing the time for developmental dysplasia of the hip screening: earlier or later? // Ultrasound Q. 2019. Vol. 35. No. 2. P. 130–135. DOI: 10.1097/RUQ.0000000000000348

[39] Federation of Medical Specialists [Internet]. DDH (dysplastic hoypontvikkeling) in childhood at the end of June 2020 [cited 2023 Nov 8]. Available from: https://richtlijnendatabase.nl/richtlijn/ddh_dysplastische_heupontwikkeling_bij_kinderen_onder_n_jaar/startpagina_-_ddh.html

[40] Federatie Medisch Specialisten [Internet]. DDH (dysplastische heupontwikkeling) bij kinderen onder één jaar. 2020 [дата обращения 08.11.2023]. Доступ по ссылке: https://richtlijnendatabase.nl/richtlijn/ddh_dysplastische_heupontwikkeling_bij_kinderen_onder_n_jaar/startpagina_-_ddh.html

[41] American Institute of Ultrasound in Medicine; American College of Radiology. AIUM practice guideline for the performance of an ultrasound examination for detection and assessment of developmental dysplasia of the hip. J Ultrasound Med. 2009;28(1):114–119. DOI: 10.7863/jum.2009.28.1.114

[42] American Institute of Ultrasound in Medicine; American College of Radiology. AIUM practice guideline for the performance of an ultrasound examination for detection and assessment of developmental dysplasia of the hip // J. Ultrasound. Med. 2009. Vol. 28. No. 1. P. 114–119. DOI: 10.7863/jum.2009.28.1.114

[43] Vukasinovic Z, Bascarevic Z. Diseases of the infant hip. Special orthopaedics. Belgrade: Banjica; 2004.

[44] Vukasinovic Z., Bascarevic Z. Diseases of the infant hip. Special orthopaedics. Belgrade: Banjica, 2004.

[45] Abakarov AA, Abakarov AA. Long-term treatment results of congenital hip disease in adolescents. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2019;7(4):87–96. (In Russ.) DOI: 10.17816/PTORS7487-96

[46] Абакаров А.А., Абакаров А.А. Отдаленные результаты лечения врожденного вывиха бедра у подростков // Ортопедия, травматология и восстановительная хирургия детского возраста. 2019. Т. 7. № 4. С. 87–96. DOI: 10.17816/PTORS7487-96

[47] Tikhilov RM, Mazurenko AV, Shubnyakov II. Results of hip arthroplasty using Paavillainen technique in patients with congenitally dislocated hip. Traumatology and Orthopedics of Russia. 2014;(1):5–15. (In Russ.) DOI: 10.21823/2311-2905-2014-0-1-5-15

[48] Тихилов Р.М., Мазуренко А.В., Шубняков И.И. Результаты эндопротезирования тазобедренного сустава с укорачивающей остеотомией по методике T. Paavillainen при полном вывихе бедра // Травматология и ортопедия России. 2014. Т. 20. № 1. С. 5–15. DOI: 10.21823/2311-2905-2014-0-1-5-15

[49] Tikhilov RM, Shubnyakov II, Kovalenko AN, et al. Data of hip arthroplasty registry of Vreden Institute for the period 2007–2012 years. Traumatology and Orthopedics of Russia. 2013;19(3):167–190. (In Russ.) DOI: 10.21823/2311-2905-2013--3-167-190

[50] Тихилов Р.М., Шубняков И.И., Коваленко А.Н., и др. Данные регистра эндопротезирования тазобедренного сустава РНИИТО им. Р.Р. Вредена за 2007–2012 годы // Травматология и ортопедия России. 2013. Т. 19. № 3. С. 167–190. DOI: 10.21823/2311-2905-2013--3-167-190