Risk factors for a false negative Ortolani and Barlow examination in developmental dysplasia of the hip.

Tan, SHS ; Lim, JXY ; et al.

In: Orthopaedics & traumatology, surgery & research : OTSR, Jg. 110 (2024-06-01), Heft 4, S. 103796

academicJournal

Introduction: Although universal screening by neonatal clinical examination with Ortolani and Barlow manoeuvres is widely adopted, its role as a sole screening tool is controversial due to its poor sensitivity and failure in identifying hip joints that eventually require surgical intervention.

Hypothesis: This study aims to identify risk factors for a false negative Ortolani and Barlow examination in neonatal screening for DDH. The hypothesis is that risk factors for developmental dysplasia of the hips could similarly be risk factors for a false negative Ortolani and Barlow examination.

Material and Methods: In the 14-year retrospective cohort study, all newborn infants born in a single institution from 1st January 1999 to 31st December 2013 were screened clinically with the Ortolani/Barlow manoeuvre by a neonatologist. Infants with positive risk factors, despite a normal clinical examination, were then scheduled for bilateral hip ultrasound in the first three months of life and evaluated according to the Graf's method, Harcke's method of dynamic ultrasound screening and Terjesen's method of evaluation for femoral head coverage.

Results: A total of 164 infants with normal Ortolani and Barlow examinations were scheduled for bilateral hip ultrasound due to the presence of risk factors. Amongst these, 32 (19.5%) infants were evaluated to have an abnormal hip on ultrasound. Breech position was the only statistically significant risk factor for a false negative Ortolani/Barlow examination (14/34, 41.2% vs. 18/112, 13.8%; p<0.001).

Discussion: Sonographic hip examinations are recommended for all infants with breech presentation even if they have a normal Ortolani and Barlow examination.

Level of Evidence: III; case-control study.

Titel:	Risk factors for a false negative Ortolani and Barlow examination in developmental dysplasia of the hip.
Autor/in / Beteiligte Person:	Tan, SHS ; Lim, JXY ; Lim, AKS ; Hui, JHP
Zeitschrift:	Orthopaedics & traumatology, surgery & research : OTSR, Jg. 110 (2024-06-01), Heft 4, S. 103796
Veröffentlichung:	Issy les Moulineaus, France : Elsevier Masson SAS,, 2024
Medientyp:	academicJournal
ISSN:	1877-0568 (electronic)
DOI:	10.1016/j.otsr.2023.103796
Schlagwort:	Humans Retrospective Studies Infant, Newborn Female Male False Negative Reactions Risk Factors Ultrasonography Physical Examination methods Hip Dislocation, Congenital diagnosis Hip Dislocation, Congenital diagnostic imaging Neonatal Screening methods Developmental Dysplasia of the Hip diagnostic imaging Developmental Dysplasia of the Hip diagnosis
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Orthop Traumatol Surg Res] 2024 Jun; Vol. 110 (4), pp. 103796. <i>Date of Electronic Publication: </i>2023 Dec 09. MeSH Terms: Neonatal Screening* / methods ; Developmental Dysplasia of the Hip* / diagnostic imaging ; Developmental Dysplasia of the Hip* / diagnosis ; Humans ; Retrospective Studies ; Infant, Newborn ; Female ; Male ; False Negative Reactions ; Risk Factors ; Ultrasonography ; Physical Examination / methods ; Hip Dislocation, Congenital / diagnosis ; Hip Dislocation, Congenital / diagnostic imaging Contributed Indexing: Keywords: Barlow; Developmental dysplasia of the hip; Ortolani; Screening Entry Date(s): Date Created: 20231211 Date Completed: 20240530 Latest Revision: 20240530 Update Code: 20240531

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