Pattern of Congenital Dislocation of the Hip in Arar City, Northern Saudi Arabia

Abstract

Background: Developmental dysplasia of the hip (DDH) is one of the most widely discussed abnormalities in neonates. The etiology of DDH is unknown. There are many insights, however, from epidemiologic/demographic information. Aim of the study: To determine the incidence, risk factors and treatment modalities of congenital dislocation of the hip (CDH) in Arar city, Northern Saudi Arabia. Methods: This is prospective study involve 955(19100hips) infants referred to Arar central hospital. During the period from 1 January 2014, to 31 December 2016, each infant was evaluated by history taking, clinical and sonographic examination for hip abnormality. Results: The incidence of (CDH) was 3.1% (73.3% were females), 70.0% of the affected had positive family history and in 46.7% there was consanguinity between parents. In 80.0% there was regular follow up during pregnancy. 16.7% had history of oligohydramnios. Breech presentation was found in 26.7% and 15.0% delivered by caesarian section. First born children constituted 25.0%. The left hip joint was more affected( 41.6%) , the right hip joint affected in  28.3% and bilateral CDH were involved in 13.3%. In the studied cases, 40.0% of the infants were treated surgically, 30% conservatively, 16% by both and 14% were referred to higher centers. Conclusion and recommendations: CDH in Arar, Central hospital and by inference in Northern region of Saudi Arabia was found to be 3.1%. Awareness programs, routine neonatal hip joint examination at birth and up to one year of age as well as ultrasound examination of pelvis in high-risk babies are strongly recommended.