Incidence of developmental dysplasia of the hip (DDH) in Helena Rehabilitation Center in Erbil city, Iraq

Abstract

Background: Developmental dysplasia of the hip (DDH) comprises a spectrum of pathology in the development of the immature hip joint ranging from mild dysplasias to complete dislocations. Epidemiological data about developmental dysplasia of the hip varies culturally and geographically. The aim of the study was to report on the sonographic incidence of developmental dysplasia of the hip in Erbil city.

Methods: A retrospective descriptive study was conducted at the Helena Rehabilitation Center in Erbil City. All infants who underwent ultrasound examination for developmental dysplasia of the hip between January 2023 to July 2023 were included. Ultrasound screening was performed using the Graf method. Bivariate and multivariable logistic regression methods were used, and independent variables were determined based on adjusted odds ratios with 95% confidence intervals and a p-value of less than 0.05.

Results: Among 533 infants, 174 were diagnosed with developmental dysplasia of the hip, including 165 with hip dysplasia and 9 with hip dislocation. The incidence of hip dysplasia in Erbil was 0.5 per 100 for hip dysplasia (95% CI, 0.4-0.6) and 0.3 per 1000 for hip dislocation (95% CI, 0.2-0.4). The incidence of hip dysplasia at Helena center was 30.9% while hip dislocation was 1.7%. Developmental dysplasia of the hip was significantly associated with a positive family history (AOR: 1.80, 95% CI: 1.21-2.66), female gender (AOR: 2.32, 95% CI: 1.58-3.42) and swaddling (AOR: 2.01, 95% CI: 1.37-2.94).

Conclusion: The incidence of developmental dysplasia of the hip in Erbil is lower than that reported in global literature. Swaddling contributes to approximately half of all developmental dysplasia of the hip cases and most hip dislocations. Female infants and those with a positive family history had a twofold increased risk of developmental dysplasia. Public health initiatives should focus on educating parents about the risks of tight swaddling.