Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population
Abstract Purpose This study evaluated the effectiveness of integrating Graf method into the universal neonatal screening program for detecting developmental dysplasia of the hip (DDH) in Taiwanese population. Methods A total of 4,667 neonates screened between May 2014 and November 2019 were enrolled...
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BMC
2025-06-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08740-7 |
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| author | Jou-Hua Wang Shu-Hsin Yao Ting-Ming Wang Chii-Jeng Lin Chang-Hao Lin Chun-Ho Chen |
| author_facet | Jou-Hua Wang Shu-Hsin Yao Ting-Ming Wang Chii-Jeng Lin Chang-Hao Lin Chun-Ho Chen |
| author_sort | Jou-Hua Wang |
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| description | Abstract Purpose This study evaluated the effectiveness of integrating Graf method into the universal neonatal screening program for detecting developmental dysplasia of the hip (DDH) in Taiwanese population. Methods A total of 4,667 neonates screened between May 2014 and November 2019 were enrolled in this study. Hip ultrasound scans were performed three days after birth, and hips were classified based on their morphology and stability. The incidence rates of early diagnosis, late diagnosis, and surgical interventions for DDH were assessed. Risk factors and treatment measures for DDH were documented. Results During the initial examination, 95.95% of hips were classified as Graf type I, while a small proportion were classified as types IIa, IIc (stable/unstable), or III. By the second examination at 4 weeks, all type IIa hips had matured to type I. A total of 35 hips (0.37%) were diagnosed with DDH and treated with a Pavlik harness before 12 weeks, resulting in an early diagnosis rate of 0.37%, with no cases of late diagnosis reported. The incidence of DDH-related surgeries was 0.04%. Multivariable logistic regression identified female sex (OR = 2.41, 95% CI: 1.05–5.52, p = 0.038) and breech presentation (OR = 6.54, 95% CI: 2.22–19.32, p < 0.001) as significant risk factors for DDH. Conclusion Universal neonatal ultrasound screening using the Graf method is simple and beneficial in the early detection and intervention of DDH. Additionally, it significantly reduces the rates of late diagnosis and the need for surgical intervention. |
| format | Article |
| id | doaj-art-3928c41069244dffbf88df8dc58ea3a2 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-3928c41069244dffbf88df8dc58ea3a22025-08-20T03:25:15ZengBMCBMC Musculoskeletal Disorders1471-24742025-06-012611610.1186/s12891-025-08740-7Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese populationJou-Hua Wang0Shu-Hsin Yao1Ting-Ming Wang2Chii-Jeng Lin3Chang-Hao Lin4Chun-Ho Chen5Department of Orthopaedic Surgery, National Cheng Kung University HospitalDepartment of Orthopedics, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Orthopaedic Surgery, National Taiwan University HospitalDepartment of Orthopaedic Surgery, National Cheng Kung University HospitalDepartment of Orthopedics, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Biomedical Engineering, National Cheng Kung UniversityAbstract Purpose This study evaluated the effectiveness of integrating Graf method into the universal neonatal screening program for detecting developmental dysplasia of the hip (DDH) in Taiwanese population. Methods A total of 4,667 neonates screened between May 2014 and November 2019 were enrolled in this study. Hip ultrasound scans were performed three days after birth, and hips were classified based on their morphology and stability. The incidence rates of early diagnosis, late diagnosis, and surgical interventions for DDH were assessed. Risk factors and treatment measures for DDH were documented. Results During the initial examination, 95.95% of hips were classified as Graf type I, while a small proportion were classified as types IIa, IIc (stable/unstable), or III. By the second examination at 4 weeks, all type IIa hips had matured to type I. A total of 35 hips (0.37%) were diagnosed with DDH and treated with a Pavlik harness before 12 weeks, resulting in an early diagnosis rate of 0.37%, with no cases of late diagnosis reported. The incidence of DDH-related surgeries was 0.04%. Multivariable logistic regression identified female sex (OR = 2.41, 95% CI: 1.05–5.52, p = 0.038) and breech presentation (OR = 6.54, 95% CI: 2.22–19.32, p < 0.001) as significant risk factors for DDH. Conclusion Universal neonatal ultrasound screening using the Graf method is simple and beneficial in the early detection and intervention of DDH. Additionally, it significantly reduces the rates of late diagnosis and the need for surgical intervention.https://doi.org/10.1186/s12891-025-08740-7Developmental dysplasia of the hipHip ultrasoundUniversal screeningNeonatal screening |
| spellingShingle | Jou-Hua Wang Shu-Hsin Yao Ting-Ming Wang Chii-Jeng Lin Chang-Hao Lin Chun-Ho Chen Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population BMC Musculoskeletal Disorders Developmental dysplasia of the hip Hip ultrasound Universal screening Neonatal screening |
| title | Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population |
| title_full | Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population |
| title_fullStr | Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population |
| title_full_unstemmed | Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population |
| title_short | Effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the Taiwanese population |
| title_sort | effectiveness of incorporating the graf method into a universal neonatal ultrasound screening program for early diagnosis of developmental dysplasia of the hip in the taiwanese population |
| topic | Developmental dysplasia of the hip Hip ultrasound Universal screening Neonatal screening |
| url | https://doi.org/10.1186/s12891-025-08740-7 |
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