255 Med Arh. 2012 Aug; 66(4): 255-257 • ORIGINAL PAPER The Importance of the First Ultrasonic Exam of Newborn Hips DOI: 10.5455/medarh.2012.66.255-257 Med Arh. 2012 Aug; 66(4): 255-257 Received: April 26th 2012 Accepted: June 02nd 2012 CONFLICT OF INTEREST: NONE DECLARED ORIGINAL PAPER The Importance of the First Ultrasonic Exam of Newborn Hips Predrag Grubor 1 , Mithat Asotic 2 , Mirza Biscevic 3 , Milan Grubor 1 Department of orthopaedics and traumatology, Clinical Centre Banja Luka, Bosnia and Herzegovina 1 PI Hospital Travnik, Travnik, Bosnia and Herzegovina 2 Department of orthopaedics and traumatology, Clinical centre of University of Sarajevo, Bosnia and Herzegovina 3 I ntroduction: Developmental hip disorder (DHD) is a disorder in development of the acetabulum which remains abrupt (dysplasia) and probably consequential cranialisation of the femur head (luxation). Aim of the paper: Te aim of this paper is to establish the total number of DHD and its subtypes at the frst clinical and ultrasound exam of newborns in a retrospective-prospective study made in the period from 1st Jan 2006 through to 31 Dec 2010 at the Clinic for orthopaedics and traumatology in Banja Luka. Materials and methods: In total 6132 patients were examined and 99 cases diagnosed with DHD (dysplasia and luxation). Ultrasonic exam was done by means of electronic probe of 5-12 MHz according to standard method after Graph. Girls were signifcantly more present (96%). Positive family anamnesis on DHD was present with 7.8% examinee, mainly with primiparas, and/ or with 77.8% children with DHD. Dominant intrauterine risk factors for DHD were: mal position of foetus in uterus (78.6%), oligoamnion (17.9%), malformation of the spinal column of the pregnant woman (3.6%), whereas with 38.4% of children with a certain form of DHD the following were found: breech presentation, caesarean section or twin pregnancy. Te clinical exam indicated DHD with 8.87% examinee, out of which hip looseness was found with 5% examinees. Ultrasonic fnding was positive with 99 examinee, that is with 1.61% of them (defcient and badly formed acetabulum, sleeked protrusion; 8 luxations and 91 dysplasia). Prophylactic measures were requested by 58.6% children (abductive bending and exercises), whereas 41.4 % needed non-intervention therapeutic measures (traction, Pavlik’s straps, Graph’s knickers, plastering), after which there were no children needing surgical correction of DHD. Conclusion: Tese data indicate that clinical exam is unreliable for DHD diagnostics, and that Ultrasonic diagnostics and treatment of DHD should start as early as possible applying atraumatic helping devices and procedures in the period when all structures are elastic, fexible and adaptable. Key words: ultrasound, newborn, screening, dysplasia, luxation. Corresponding author: prof. Predrag Grubor, MD, PhD. Aleja Svetog Save 20/24. 78000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina. Tel: 00 387 51 221 360. E-mail: predraggrubor@gmail.com 1. INTRODUCTION Developmental hip disorder (DHD) denotes prenatal and early post natal defcient development of lateral part of acetabulum with possible consequential dislocation of the femur head (lateral- ization and cranialization) (1). Te term “developmental hip disorder” (DHD) is most appropriate because it includes all stages in the development of this mal- formation and every stage of child de- velopment (2, 3). During the time of intrauterine life, conditions for DHD are created when the hip is dominantly cartilaginous, and the head is encircled with shallow acetabulum. Joint capsule is loose and intrauterine pressure is transmitted to big trochanter in one of luxable positions (4, 5). Joint capsule is stretched together with lig. capitis fem- oris which becomes fattened, and pelvi- trochanter musculature pulls the head of femur cranially and laterally (6). Te joint capsule twists around longitudi- nal axis creating a narrow part (isth- mus capsulae) in the form of an hour- glass, due to which surgical interven- tion must be done (7). Upon deliv- ery luxated hip is released from unfa- vourable mechanical factors and about one half of cases stabilize spontane- ously and evolve into complete or par- tial healing (mild residual dysplasia) (8, 9, 10, 11). Nevertheless, in other cases hips remain more severely dysplastic or even unstable, and/or luxated. Tey need to be recognized by timely clinical, ultrasonic, and, when needed, radio- graph diagnostics, then classifed and properly treated. Ultrasonic screening