Newborn hip screening experience in Türkiye

Abstract

In this review article, newborn hip screening experience in Türkiye was summarized. The nationwide newborn hip screening program was officially initiated in 2013. The program currently includes the ultrasonographic examination of the hips of almost all newborns within the first two months of life. The rate of minor surgical interventions (closed/open reduction and casting) was 0.47 per 1,000 live births in 2015 and was 0.89 per 1,000 live births in 2020. Thus, an increase of 89% in the rate of minor surgical interventions was observed. The rate of major surgical interventions (pelvic/femoral osteotomies) was 0.74 per 1,000 live births in 2015 and was 0.21 per 1,000 live births in 2020. Thus, a decrease of 72% in the rate of major surgical interventions was observed between 2015 and 2020. While minor surgical interventions constituted about 39% of the overall surgical interventions in 2015, this ratio raised to 81% in 2020. Based on the experiences in Türkiye universal newborn ultrasonography (US) hip screening is advocated to lessen the rate of extensive surgeries in developmental dysplasia of the hip (DDH) during childhood and adulthood and to have as many as possible functional hips in the long-term follow-up of patients with DDH.

Keywords

Developmental dysplasia of the hip / hip ultrasonography / newborn hip screening

References

[1] Tumer Y, Omeroglu H. Prevention of developmental dysplasia of the hip in Turkey. Acta Orthop Traumatol Turc. 1997; 31: 176-81. Turkish.

[2] Songur M, Akel I, Karahan S, Kuzgun U, Tumer Y. Prevalence of untreated hip dislocation in Turkish children aged 6 months to 14 years. Acta Orthop Traumatol Turc. 2011; 45: 215-20.

[3] Ulucay C, Ozler T, Guven M, Akman B, Kocadag AO, Altintas F. Etiology of coxarthrosis in patients with total hip replacement. Acta Orthop Traumatol Turc. 2013; 47: 330-3.

[4] Kapicioglu MI, Korkusuz F. Diagnosis of developmental dislocation of the hip by sonospectrography. Clin Orthop Relat Res. 2008; 466: 802-8.

[5] Chakirgil GS. Radical reduction operation in the treatment of congenital dislocation of the hip. An analysis of 2,789 cases. Orthopedics. 1987; 10: 711-20.

[6] Korkusuz Z. A new technic in the surgical treatment of congenital hip dislocation. Z Orthop Ihre Grenzgeb. 1986; 124: 252-5. German.

[7] Ömeroğlu H, Yazıcı M. Professor Yücel Tümer, MD; a legend, mentor in children’s orthopaedics in Turkey. Acta Orthop Traumatol Turc. 2021; 55: 85-6.

[8] Graf R, Tschauner C, Klapsch W. Progress in prevention of late developmental dislocation of the hip by sonographic newborn hip “screening”: results of a comparative follow up study. J Pediatr Orthop B. 1993; 2: 115-21.

[9] Kapicioğlu MIS, Karataş AF, Akkaya M, Korkusuz F, Ömeroğlu H. Six years of experience with the nationwide newborn ultrasonographic hip screening program in Turkey: a considerable change in the type of surgical interventions in developmental dysplasia of the hip. J Pediatr Orthop B. 2023;[Epub ahead of print].

[10] Omeroğlu H, Koparal S. The role of clinical examination and risk factors in the diagnosis of developmental dysplasia of the hip: a prospective study in 188 referred young infants. Arch Orthop Trauma Surg. 2001; 121: 7-11.

[11] Karapinar L, Sürenkök F, Oztürk H, Us MR, Yurdakul L. The importance of predicted risk factors in developmental hip dysplasia: an ultrasonographic screening program. Acta Orthop Traumatol Turc. 2002; 36: 106-10. Turkish.

[12] Sahin F, Aktürk A, Beyazova U, Cakir B, Boyunaga O, Tezcan S, et al. Screening for developmental dysplasia of the hip: results of a 7-year follow-up study. Pediatr Int. 2004; 46: 162-6.

[13] Senaran H, Ozdemir HM, Ogün TC, Kapicioglu MI. Value of limited hip abduction in developmental dysplasia of the hip. Pediatr Int. 2004; 46: 456-8.

[14] Tuncay IC, Karaeminogullari O, Demirörs H, Tandogan NR. Is prematurity important in ultrasonographic hip typing? J Pediatr Orthop B. 2005; 14: 168-71.

[15] Köse N, Omeroğlu H, Ozyurt B, Akçar N, Ozçelik A, Inan U, et al. Our three-year experience with an ultrasonographic hip screening program conducted in infants at 3 to 4 weeks of age. Acta Orthop Traumatol Turc. 2006; 40: 285-90. Turkish.

[16] Dogruel H, Atalar H, Yavuz OY, Sayli U. Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip. Int Orthop. 2008; 32: 415-9.

[17] Koşar P, Ergun E, Yiğit H, Gökharman FD, Kosar U. Developmental dysplasia in male infants: risk factors, instability and ultrasound screening. Hip Int. 2011; 21: 409-14.

[18] Omeroğlu H, Caylak R, Inan U, Köse N. Ultrasonographic graf type IIa hip needs more consideration in newborn girls. J Child Orthop. 2013; 7: 95-8.

[19] Çekiç B, Erdem-Toslak İ, Sertkaya Ö, Filiz S, Kılar Y, Köroğlu M, et al. Incidence and follow-up outcomes of developmental hip dysplasia of newborns in the Western Mediterranean Region. Turk J Pediatr. 2015; 57: 353-8.

[20] Güler O, Şeker A, Mutlu S, Çerçi MH, Kömür B, Mahiroğulları M. Results of a universal ultrasonographic hip screening program at a single institution. Acta Orthop Traumatol Turc. 2016; 50: 42-8.

[21] Kural B, Devecioğlu Karapınar E, Yılmazbaş P, Eren T, Gökçay G. Risk factor assessment and a ten-year experience of DDH screening in a well-child population. Biomed Res Int. 2019; 2019: 7213681.

[22] Ömeroğlu H, Akceylan A, Köse N. Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study. J Child Orthop. 2019; 13: 161-6.

[23] Bozkurt C, Sarıkaya B, Sipahioğlu S, Altay MA, Çetin BV, Bekin Sarıkaya PZ. Effects of developmental dysplasia of the hip screening program on the treatment strategies: a retrospective study from a tertiary care hospital in the southeast region of Turkey. Acta Orthop Traumatol Turc. 2021; 55: 396-401.

[24] Çetin BV, Bakırcıoğlu S, Çiftci S, Söylemez MS, Erkuş S, Turhan Y, et al. Management preferences of orthopedic surgeons in developmental dysplasia of the hip under 1 year of age in Türkiye: results of a nationwide cross-sectional survey. Acta Orthop Traumatol Turc. 2023; 57: 322-8.