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Review paper

The predictive value of the clinical sign of limited hip abduction for developmental dysplasia of the hip (DDH)

By
Svemir Čustović Orcid logo ,
Svemir Čustović
Contact Svemir Čustović

Orthopaedics and Traumatology Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Department of Orthopaedics, School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Sahmir Šadić ,
Sahmir Šadić

Department of Orthopaedics, School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Orthopaedics and Traumatology Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Aleksandar Vujadinović ,
Aleksandar Vujadinović

Orthopaedics and Traumatology Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Department of Orthopaedics, School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Asmir Hrustić ,
Asmir Hrustić

Department of Orthopaedics, School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Orthopaedics and Traumatology Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Mahir Jašarević ,
Mahir Jašarević

Orthopaedics and Traumatology Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Department of Orthopaedics, School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Amer Čustović ,
Amer Čustović

Department of Orthopaedics, School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Department of Sanitary and Epidemiological Surveillance, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Ferid Krupić
Ferid Krupić

Department of Orthopaedics , Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden

Department of Orthopaedics, Sahlgrenska University Hospital Molndal , Molndal , Sweden

Abstract

Aim
To assess the relationship between the clinical sign of limited hip abduction and developmental dysplasia of the hip (DDH). Methods
A research was conducted on 450 newborns at the Neonatal Unit at the Clinic of Gynaecology and Obstetrics and the Orthopaedics and Traumatology Clinic of the University Clinical Centre, Tuzla, between 30 th August 2011 and 30 th April 2012. Clinical (degree of hip abduction) and ultrasound examination of all newborns' hips were performed using the Graf method on their first day of life.
Results
Clinical sign of limited hip abduction showed significant predictive value for DDH. There were 67 (14.7%) newborns with the clinical sign of limited hip abduction, of which 26 (5.7%) were on the left hip, 11 (2.4%) on the right hip and 30 (6.6%) on both hips. Limited hip abduction had a positive predictive value (PPV) of 40.3% and a negative predictive value (NPV) of 80.4% for DDH.
Conclusion
Limited hip abduction, especially unilateral, is a useful and important clinical sign of DDH. Doctors, who perform the first examination of the child after birth, would have to pay attention to this clinical sign. Newborns with this clinical sign would have to go to an ultrasound examination of the hips for further diagnosis.

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