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Vaidya S, Aroojis A, Mehta R. Developmental Dysplasia of Hip and Post-natal Positioning: Role of Swaddling and Baby-Wearing. Indian J Orthop 2021; 55:1410-1416. [PMID: 35003533 PMCID: PMC8688658 DOI: 10.1007/s43465-021-00513-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/02/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Traditional swaddling, which implies restrictive immobilisation of the infant's lower limbs with the hips in forced extension and adduction, has been shown to be a risk factor for Developmental Dysplasia of Hip (DDH). METHODS We reviewed the literature regarding the correlation between DDH and post-natal positioning by swaddling and baby-wearing, to draw awareness of healthcare professionals towards an important risk factor for DDH that has often been overlooked. RESULTS There is overwhelming evidence in the literature, by both experimental and clinical studies, that proves the close association between improper post-natal positioning of the baby's hips in extension-adduction and an increased incidence of DDH. On the other hand, "hip safe" swaddling which allows unrestricted flexion-abduction movements of the infants' hips, and the use of baby-wearing devices which keep the lower limbs in an attitude of hip flexion-abduction and knee flexion, is optimal for hip development. Populations which practice these "hip-safe" techniques of infant immobilisation have a lower incidence of DDH as compared to those which practice restrictive immobilisation. Furthermore, populations which have adopted "hip-safe" positioning have demonstrated a significant decrease in the incidence of DDH. Understanding this association is vital, since this is a modifiable risk factor, rectification of which can decrease the incidence of DDH. CONCLUSION Policy makers and governments must design educational campaigns tailored to their respective populations to increase awareness regarding the benefits of "hip-safe" techniques of infant positioning, since this simple intervention has the potential of decreasing the incidence of DDH.
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Affiliation(s)
- Sandeep Vaidya
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Mumbai, 40012 Maharashtra India
| | - Alaric Aroojis
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Mumbai, 40012 Maharashtra India
| | - Rujuta Mehta
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Mumbai, 40012 Maharashtra India
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Pinto DA, Aroojis A, Mehta R. Swaddling Practices in an Indian Institution: Are they Hip-Safe? A Survey of Paediatricians, Nurses and Caregivers. Indian J Orthop 2020; 55:147-157. [PMID: 33569109 PMCID: PMC7851204 DOI: 10.1007/s43465-020-00188-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/25/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Traditional infant swaddling or binding with hips and knees extended is a known risk factor for Developmental Dysplasia of the Hip (DDH), while 'hip-safe swaddling' with hips and knees flexed is believed to eliminate this risk. We conducted a survey to determine the prevalent practices for infant swaddling in India; why mothers practice swaddling and who teaches them; and whether Paediatricians, nurses and caregivers are aware of hip-safe swaddling. METHODS Anonymous one-time surveys were conducted in three groups-Paediatricians, Nurses and caregivers - at a tertiary-care, urban based, paediatric and maternity hospital. RESULTS Forty-five paediatricians, 219 nurses and 100 caregivers were surveyed. Ninety percent caregivers practiced traditional swaddling, for on average 10.2 hours a day, starting soon after birth, up to 4.2 months of life. Traditional swaddling was advocated by 99% nurses and 53% Paediatricians. Reasons for swaddling included sleep, warmth and the misbelief that the child's legs would remain bowed if not bound straight; contrarily few mothers (8%) avoided swaddling out of superstition. Mothers learnt swaddling mainly from relatives (94%) and nurses (64%). Most nurses (70%) had learnt the practice during nursing training. Only 6.6% Paediatricians, 4% caregivers and 0% nurses were aware of 'hip-safe swaddling'. CONCLUSION Traditional swaddling of infants is a practice deeply rooted in India, born out of misbeliefs, and propagated by lack of awareness. Training in hip-safe swaddling targeted at nurses and Paediatricians would be an effective initial step in creating awareness among mothers and changing their practices.
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Affiliation(s)
- Deepika A. Pinto
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Alaric Aroojis
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012 Maharashtra India
| | - Rujuta Mehta
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012 Maharashtra India
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Sueyoshi T, Ritter MA, Davis KE, Loder RT. Seasonal variation in adult hip disease secondary to osteoarthritis and developmental dysplasia of the hip. World J Orthop 2016; 7:821-825. [PMID: 28032035 PMCID: PMC5155258 DOI: 10.5312/wjo.v7.i12.821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/19/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis (OA) or sequelae of developmental dysplasia of the hip (DDH).
METHODS The total hip registry from the author’s institution for the years 1969 to 2013 was reviewed. The month of birth, age, gender, and ethnicity was recorded. Differences between number of births observed and expected in the winter months (October through February) and non-winter mo (March through September) were analyzed with the χ2 test. Detailed temporal variation was mathematically assessed using cosinor analysis.
RESULTS There were 7792 OA patients and 60 DDH patients who underwent total hip arthroplasty. There were more births than expected in the winter months for both the DDH (P < 0.0001) and OA (P = 0.0052) groups. Cosinor analyses demonstrated a peak date of birth on 1st October.
CONCLUSION These data demonstrate an increased prevalence of DDH and OA in those patients born in winter.
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Giorgi M, Carriero A, Shefelbine SJ, Nowlan NC. Effects of normal and abnormal loading conditions on morphogenesis of the prenatal hip joint: application to hip dysplasia. J Biomech 2015; 48:3390-7. [PMID: 26163754 PMCID: PMC4601017 DOI: 10.1016/j.jbiomech.2015.06.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 06/04/2015] [Accepted: 06/15/2015] [Indexed: 01/01/2023]
Abstract
Joint morphogenesis is an important phase of prenatal joint development during which the opposing cartilaginous rudiments acquire their reciprocal and interlocking shapes. At an early stage of development, the prenatal hip joint is formed of a deep acetabular cavity that almost totally encloses the head. By the time of birth, the acetabulum has become shallower and the femoral head has lost substantial sphericity, reducing joint coverage and stability. In this study, we use a dynamic mechanobiological simulation to explore the effects of normal (symmetric), reduced and abnormal (asymmetric) prenatal movements on hip joint shape, to understand their importance for postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). We successfully predict the physiological trends of decreasing sphericity and acetabular coverage of the femoral head during fetal development. We show that a full range of symmetric movements helps to maintain some of the acetabular depth and femoral head sphericity, while reduced or absent movements can lead to decreased sphericity and acetabular coverage of the femoral head. When an abnormal movement pattern was applied, a deformed joint shape was predicted, with an opened asymmetric acetabulum and the onset of a malformed femoral head. This study provides evidence for the importance of fetal movements in the prevention and manifestation of congenital musculoskeletal disorders such as DDH.
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Affiliation(s)
- Mario Giorgi
- Department of Bioengineering, Imperial College London, UK
| | - Alessandra Carriero
- Department of Bioengineering, Imperial College London, UK; Department of Biomedical Engineering, Florida Institute of Technology, USA
| | - Sandra J Shefelbine
- Department of Bioengineering, Imperial College London, UK; Department of Mechanical and Industrial Engineering, Northeastern University, USA
| | - Niamh C Nowlan
- Department of Bioengineering, Imperial College London, UK.
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Loder RT, Shafer C. Seasonal variation in children with developmental dysplasia of the hip. J Child Orthop 2014; 8:11-22. [PMID: 24500336 PMCID: PMC3935022 DOI: 10.1007/s11832-014-0558-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 01/13/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND It has been postulated that developmental dysplasia of the hip (DDH) is more frequent in infants born in the winter months. It was the purpose of this study to ascertain if there was any seasonal variation in DDH at the author's institution and compare/contrast our results with those in the literature using rigorous mathematical fitting. METHODS All children with DDH treated at the author's institution from 1993 to 2012 were identified. The month of birth was recorded and temporal variation was analyzed using cosinor analysis. Similar data from the literature was analyzed. RESULTS There were 424 children (363 girls, 61 boys). An additional 22,936 children were added from the literature for a total of 23,360. Pearson's Chi-square test demonstrated a non-uniform distribution in the month of birth for both our 424 children as well as the combined literature series in both the Northern and Southern hemispheres. Cosinor analysis of the 424 children demonstrated double peaks in mid-March and mid-October. For the entire 23,360 children, no seasonal variation was observed in 2,205 (9.4 %), a single winter peak in 16,425 (70.3 %), a single summer peak in 1,280 (5.5 %), and double peaks in the spring and autumn in 3,450 (14.8 %). CONCLUSIONS This study partly supports the hypothesis of tight clothing/cold temperature as one factor in the etiology of DDH with the tighter clothing/swaddling increasing the risk of DDH. However ~20 % of the DDH births demonstrated a non-winter peak. The single summer and double spring/autumn peaks, as well as in those series where no seasonal variation was noted, refutes the cold winter clothing hypothesis. Perhaps these different patterns in seasonal variation represent the heterogeneity of the genetic factors in DDH interacting with external factors (temperature and clothing) and internal factors (metabolic). Further study will be required to understand these different patterns in DDH seasonal variation. LEVEL OF EVIDENCE IV-case series.
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Affiliation(s)
- Randall T Loder
- Department of Orthopaedic Surgery, Indiana School of Medicine, James Whitcomb Riley Children's Hospital, Indiana University, ROC 4250, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA,
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Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN ORTHOPEDICS 2011; 2011:238607. [PMID: 24977057 PMCID: PMC4063216 DOI: 10.5402/2011/238607] [Citation(s) in RCA: 175] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 06/17/2011] [Indexed: 12/18/2022]
Abstract
The etiology of developmental dysplasia of the hip (DDH) is unknown. There are many insights, however, from epidemiologic/demographic information. A systematic medical literature review regarding DDH was performed. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%). The incidence per 1000 live births ranges from 0.06 in Africans in Africa to 76.1 in Native Americans. There is significant variability in incidence within each racial group by geographic location. The incidence of clinical neonatal hip instability at birth ranges from 0.4 in Africans to 61.7 in Polish Caucasians. Predictors of DDH are breech presentation, positive family history, and gender (female). Children born premature, with low birth weights, or to multifetal pregnancies are somewhat protected from DDH. Certain HLA A, B, and D types demonstrate an increase in DDH. Chromosome 17q21 is strongly associated with DDH. Ligamentous laxity and abnormalities in collagen metabolism, estrogen metabolism, and pregnancy-associated pelvic instability are well-described associations with DDH. Many studies demonstrate an increase of DDH in the winter, both in the northern and southern hemispheres. Swaddling is strongly associated with DDH. Amniocentesis, premature labor, and massive radiation exposure may increase the risk of DDH. Associated conditions are congenital muscular torticollis and congenital foot deformities. The opposite hip is frequently abnormal when using rigorous radiographic assessments. The role of acetabular dysplasia and adult hip osteoarthritis is complex. Archeological studies demonstrate that the epidemiology of DDH may be changing.
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Affiliation(s)
- Randall T. Loder
- Section of Orthopedic Surgery, Riley Hospital for Children, ROC 4250, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA
- Department of Orthopaedic Surgery, Indiana University, Indianapolis, IN 46202, USA
| | - Elaine N. Skopelja
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Chan A, McCaul KA, Cundy PJ, Haan EA, Byron-Scott R. Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 1997; 76:F94-100. [PMID: 9135287 PMCID: PMC1720627 DOI: 10.1136/fn.76.2.f94] [Citation(s) in RCA: 141] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS To identify perinatal risk factors for developmental dysplasia of the hip (DDH) and define the risk for each factor. METHODS In this case control study, using logistic regression analysis, all 1127 cases of isolated DDH live born in South Australia in 1986-93 and notified to the South Australian Birth Defects Register were included; controls comprised 150130 live births in South Australia during the same period without any notified congenital abnormalities. RESULTS Breech presentation, oligohydramnios, female sex and primiparity were confirmed as risk factors for DDH. Significant findings were an increased risk for vaginal delivery over caesarean section for breech presentation (as well as an increased risk for emergency section over elective section), high birthweight (> or = 4000 g), postmaturity and older maternal age; multiple births and preterm births had a reduced risk. There was no increased risk for caesarean section in the absence of breech presentation. For breech presentation, the risk of DDH was estimated to be at least 2.7% for girls and 0.8% for boys; a combination of factors increased the risk. CONCLUSIONS It is suggested that the risk factors identified be used as indications for repeat screening at 6 weeks of age and whenever possible in infancy. Other indications are family history and associated abnormalities.
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Affiliation(s)
- A Chan
- Pregnancy Outcome Unit, South Australian Health Commission, Adelaide
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Jones DA. Principles of screening and congenital dislocation of the hip. Ann R Coll Surg Engl 1994; 76:245-50. [PMID: 8074385 PMCID: PMC2502242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The call for screening for an increasing number of surgical diseases is becoming louder and more frequent. There is a general perception that screening is 'good' but it is important to consider the evidence carefully. There is one surgical disease that provides considerable experience of the process of screening over a period of 30 years and this is congenital dislocation of the hip (CDH). In retrospect, it is clear that screening for this disease has not been a total success. Although some specialised centres have achieved excellent results, in the country as a whole screening has been a failure. The reasons for this are analysed and emphasis is placed on the principles of screening which are briefly summarised. The results of various studies on screening and experiments on the basic functional anatomy of the neonatal hip are described. The initial results of our method of selective ultrasound screening appear to be encouraging and some evidence of a possible collagen abnormality in CDH is presented. As a general principle, however, it is suggested that strict randomised controlled trials should take place before national screening programmes are started.
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Affiliation(s)
- D A Jones
- Department of Children's Orthopaedic Surgery, School of Postgraduate Medical and Health Care Studies, Morriston Hospital, Swansea
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Knox EG, Armstrong EH, Lancashire RJ. Effectiveness of screening for congenital dislocation of the hip. J Epidemiol Community Health 1987; 41:283-9. [PMID: 3455421 PMCID: PMC1052648 DOI: 10.1136/jech.41.4.283] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The incidence of congenital dislocation of the hip (CDH) in Birmingham was measured in the period 1942-52 and again in 1950-54; it is measured now in 1974-83. Despite the introduction of neonatal screening for CDH in November 1966, between the times of the earlier and the present measurements there was no indication that CDH requiring prolonged treatment had declined. The performance of the procedure itself was poor. It detected only a third of genuine cases, and the false positives outnumbered the true positives by 10:1. The incidence of 'definite' cases varied markedly from year to year in a manner suggesting diagnostic idiosyncracies rather than genuine fluctuations. There was no evidence in particular maternity units that high levels of early detection led to low levels of late diagnosis. Indeed, maternity units with the worst results--the highest rates of late diagnosis and of prolonged treatment--had the highest rates of early detection and early treatment. Current theories of natural history, aetiology, and treatment should be reappraised.
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Affiliation(s)
- E G Knox
- Department of Social Medicine, University of Birmingham, Medical School, Edgbaston
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Wynne-Davies R, Littlejohn A, Gormley J. Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis). J Med Genet 1982; 19:321-8. [PMID: 7143383 PMCID: PMC1048914 DOI: 10.1136/jmg.19.5.321] [Citation(s) in RCA: 78] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the idiopathic forms of talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile scoliosis. A survey of 165 patients now aged 7 to 11 years showed an aetiological relationship, but with differing environmental factors. These factors were established by comparison with the Edinburgh Register control group of 692 normal infants born over the same period, giving a unique opportunity to obtain more accurate antenatal data than has previously been possible. The principal associations were: talipes equinovarus with antepartum haemorrhage and maternal hypertension; metatarsus varus with twin pregnancies; congenital dislocation of the hip with first born children, older than average fathers, breech presentation, a significant lack of menstrual problems in the mother, and maternal upper respiratory infection during pregnancy; infantile idiopathic scoliosis with breech presentation, prematurity, and the onset of the curve in the winter months. No significant association with raised intrauterine pressure (hydramnios or oligohydramnios) was found among these simple idiopathic deformities. It is concluded that the multifactorial genetic background in likely to be similar in all, but that the additional environmental element is variable.
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Abstract
The efficacy of neonatal screening for congenital disease of the hip is reviewed in relation to currently accepted criteria. There is poor validity of the tests used, imperfect understanding of the natural history of the condition, and absence of information on the outcome of treatment following screening compared to that following conventional diagnosis. The benefits of screening, although probably real, are therefore difficult to quantify. Strategies for increasing the efficiency of screening (maximizing the benefit:cost ratio) by mass screening after the neonatal period or by instituting routine retesting of all infants are discussed.
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Specht EE. Congenital dislocation of the hip. West J Med 1976; 124:18-28. [PMID: 1251603 PMCID: PMC1129961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Congenital dislocation or subluxation of the hip (congenital acetabular dysplasia) is a complete or partial displacement of the femoral head out of the acetabulum. The physical signs essential for diagnosis are age related. In newborns the tests for instability are the most sensitive. After the neonatal period, and until the age of walking, tightness of the adductor muscles is the most reliable sign. Early diagnosis is vital for successful treatment of this partially genetically determined condition. Various therapeutic measures, ranging from abduction splinting to open reduction and osteotomy, may be required. Following diagnosis in the first month of life, the average treatment time in one recent series was only 2.3 months from initiation of therapy to attainment of a normal hip. When the diagnosis was not made until 3 to 6 months of age, ten months of treatment was required to achieve the same outcome. When the diagnosis is not made, or the treatment is not begun until after the age of 6, a normal hip will probably not develop in any patient.
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Czeizel A, Szentpétery J, Tusnády G, Vizkelety T. Two family studies on congenital dislocation of the hip after early orthopaedic screening Hungary. J Med Genet 1975; 12:125-30. [PMID: 1142376 PMCID: PMC1013253 DOI: 10.1136/jmg.12.2.125] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Two family studies involving 1767 and 379 index patients in Budapest and Bekes county, respectively, were undertaken to examine the effect of early orthopaedic screening on the recurrence risk of congenital dislocation of the hip. About 14%, 2.1-2.3%,1.2-1.4%, and 4.7-6% of sibs, parents, uncles and aunts, and cousins, respectively, had congenital dislocation of the hip in these two surveys. The recurrence risks were eight-fold and four-fold higher in brothers and sisters, four times higher in parents, 2.5-fold higher in uncles and aunts, and 2.0-2.5 times higher in cousins, respectively, than in the general population. This family pattern seems to fit best with a model of polygenic-multifactorial inheritance. In earlier studies higher recurrence risks were found. These may be explained by the change of diagnosis due to early orthopaedic screening which may increase the possibility of over diagnosis and the treatment of mild cases which previously recovered spontaneously.
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Wynne-Davies R. A family study of neonatal and late-diagnosis congenital dislocation of the hip. J Med Genet 1970; 7:315-33. [PMID: 5501696 PMCID: PMC1468960 DOI: 10.1136/jmg.7.4.315] [Citation(s) in RCA: 77] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Woolf CM, Koehn JH, Coleman SS. Congenital hip disease in Utah: the influence of genetic and nongenetic factors. Am J Hum Genet 1968; 20:430-9. [PMID: 5701615 PMCID: PMC1706343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Drillien CM. Studies in mental handicap. II. Some obstetric factors of possible aetiological significance. Arch Dis Child 1968; 43:283-94. [PMID: 5690053 PMCID: PMC2019971 DOI: 10.1136/adc.43.229.283] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Salter RB. Etiology, pathogenesis and possible prevention of congenital dislocation of the hip. CANADIAN MEDICAL ASSOCIATION JOURNAL 1968; 98:933-45. [PMID: 5690507 PMCID: PMC1924151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Finlay HV, Maudsley RH, Busfield PI. Dislocatable hip and dislocated hip in the newborn infant. BRITISH MEDICAL JOURNAL 1967; 4:377-81. [PMID: 6054913 PMCID: PMC1748717 DOI: 10.1136/bmj.4.5576.377] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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RABIN DL, BARNETT CR, ARNOLD WD, FREIBERGER RH, BROOKS G. UNTREATED CONGENITAL HIP DISEASE. A STUDY OF THE EPIDEMIOLOGY, NATURAL HISTORY, AND SOCIAL ASPECTS OF THE DISEASE IN A NAVAJO POPULATION. Am J Public Health Nations Health 1965; 55:SUPPL:1-44. [PMID: 14275466 PMCID: PMC1256104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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FRASER GR, CALNAN JS. Cleft lip and palate: seasonal incidence, birth weight, birth rank, sex, site, associated malformations and parental age. A statistical survey. Arch Dis Child 1961; 36:420-3. [PMID: 13701506 PMCID: PMC2012702 DOI: 10.1136/adc.36.188.420] [Citation(s) in RCA: 101] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Persistent Ductus Arteriosus. BRITISH MEDICAL JOURNAL 1961; 2:225-226. [PMID: 20789198 PMCID: PMC1969085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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McDONALD AD, RECORD RG, SMITH JAM. Symposium on Events in Pregnancy in Relation to Disease and Defects in the Infant. Proc R Soc Med 1958; 51:146-50. [PMID: 13527502 PMCID: PMC1889584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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