ArticleEuropean journal of pediatrics2017
Diagnosing developmental dysplasia of the hip using the Graf ultrasound method: risk and protective factor analysis in 11,820 universally screened newborns.
Article in European journal of pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07488260 (Evaluation of the Concordance Between the Software Application and Standard Ultrasound Assessment in Classifying Hip Types in Infants Screened for Developmental Dysplasia of the Hip), which is not on this map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of the Concordance Between the Software Application and Standard Ultrasound Assessment in Classifying Hip Types in Infants Screened for Developmental Dysplasia of the Hip (DDH)
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Risk Factors for Developmental Dysplasia of the Hip Before 3 Months of Age: A Meta-Analysis.JAMA network open · 2025Pooled it
- Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Revisiting selected risk factors and their association with ultrasonographic hip types in developmental dysplasia of the hip: a multivariate regression analysis.BMC pediatrics · 2026Article
- 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 · 2025Article
- Exploring the impact of developmental dysplasia of the hip on refugees with temporary protected status in Türkiye.Journal of children's orthopaedics · 2025Article
- Impact of probe tilt on Graf ultrasonography accuracy for neonatal hip dysplasia screening.SICOT-J · 2025Article
- Ultrasonographic screening for developmental dysplasia of the hip: the Graf method revisited.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Review
- Birthweight correlates to pubo-femoral distances and α angles in hip ultrasound of newborns at 6 weeks of age: a retrospective cohort study.Acta orthopaedica · 2023Article
- Developmental Dysplasia of the Hip: How Many Risk Factors Are Needed?Children (Basel, Switzerland) · 2023Article
- Fifty percent of patients undergoing periacetabular osteotomy for hip dysplasia showed normal findings upon neonatal ultrasound screening : Symptomatic hip dysplasia in adulthood despite inconspicuous neonatal hip ultrasound.Orthopadie (Heidelberg, Germany) · 2023Article
- Concentric Circles: A New Ultrasonographic Sign for the Diagnosis of Normal Infantile Hip Development.Children (Basel, Switzerland) · 2023Article
- Incidence and Epidemiological Characters of Developmental Dysplasia of the Hip in Lianyungang: Based on Ultrasound Screening: A Retrospective Study.International journal of general medicine · 2022Article
- Developmental dysplasia of the hip: real world data from a retrospective analysis to evaluate the effectiveness of universal screening.Journal of ultrasound · 2021Article
- Early neonatal universal ultrasound screening for developmental dysplasia of the hip: a single institution observational study.International orthopaedics · 2021Observational
- Timing for closed reduction procedure for developmental dysplasia of the hip and its failure analysis.BMC musculoskeletal disorders · 2020Article
- Treatment of unstable hips with the Tübingen splint in early postnatal period: radiological mid-term results of 75 hips with mean follow-up of 5.5 years.Journal of children's orthopaedics · 2020Article
- Profile of Patients Diagnosed with Developmental Dysplasia of the Hip.Revista brasileira de ortopedia · 2019Article
- Developmental dysplasia of the hip in children with Down syndrome: comparison of clinical and radiological examinations in a local cohort.European journal of pediatrics · 2019Article
- Surgical procedures in infants with early diagnoses of developmental dysplasia of the hip. A prospective 4-year follow-up study.Journal of orthopaedicsArticle
- Developmental dysplasia of the hip in infants referred for a combined pediatric orthopedic and radiologic examination. A prospective cohort study.Journal of orthopaedicsArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The essential role of ultrasound examinations in diagnosis and treatment of developmental dysplasia of the hip (DDH) is widely accepted while the weighting and correlation of protective factors and perinatal risk for DDH still give rise to debate. Our aim was to investigate the impact of single and twofold combined risk and protective factors on the newborns' hip maturity, assessed with the Graf ultrasound method. Therefore, data sets of 11,820 universally screened newborns were analyzed. Univariate and logistic regression analyses were performed to correlate risk and protective factors with mature or immature but appropriate for age and pathologic hip types. Thereby, female gender (OR 4.07 (95% CI 3.01-5.51), p < 0.001), breech presentation (4.98 (3.71-6.71), p < 0.001), and positive family anamnesis (5.05 (3.49-7.31), p < 0.001) as well as the combination of female gender with high birth weight (3.51 (2.45-5.03), p < 0.001) could be identified as independent predictive risk factors. Only low birth weight (0.27 (0.11-0.66), p = 0.004) could be identified as a single protective factor, while no combination of protective factors was significant.
conclusionThe significance and the informative value of risk and protective factor combinations, e.g., for selective ultrasound surveys, are limited. Early universal ultrasound screening using the Graf method is advised to timely detect hip immaturity and pathologies and to provide the optimal approach for mature or immature but appropriate for age and pathologic hips. What is Known: • Ultrasound screening is essential for diagnosis and treatment of DDH in time while the weighting and correlation of protective factors and perinatal risk and their role for the ultrasound screening protocol still give rise to debate. What is New: • The effects of single risk and protective factors for DDH do not cumulate or counteract, resulting in a limited value of a selective screening protocol based on risk and protective factors. • A universal screening protocol using the Graf ultrasound method is recommended.
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