Vol. 11, No 1, 2004 pp. 26 - 30
UC 611.96-053.31:616-071
EARLY DIAGNOSIS OF DEVELOPMENTAL HIP DYSPLASIA
IN THE DISTRICT OF PIROT, SERBIA
Nenad Zdravković, Siniša Stojanović
Medical Center, Pirot, Serbia
Summary. Developmental dysplasia of the hip (DDH) is a major health
problem leading in untreated babies to permanent disability. Costs for
treatment, surgery and rehabilitation of these cases are much higher than
for relatively simple prevention. A relatively simple ultrasound screening
method, according to Graf, has permitted an early diagnosis and treatment
of DDH. The aim of this work was to analyze the early diagnosis and prevention
of DDH in the district of Pirot. The following periods were analyzed:1)
From 1985 to 1988, when diagnosis of DDH was made on the basis of clinical
examination and radiology of the hips in the sixth month of life; 2) From
1989 to 1999, when diagnosis of DDH was made by clinical examination and
ultrasound of the hips; from 1989 to 1992 in the fourth/fifth month, and
from 1993 to 1999 in the third month of life. Hip ultrasound screening
from 1989 to 1992 revealed DDH in 0.88% of boys and 2.49% of girls. Screening
in the third month of life, from 1993 to 1998 has revealed DDH in 0.21%
of boys and 1.35% of girls, significantly less than in the previous period.
The treatment of DDH is recommended in the first six weeks of life, at
least in the third month of life. Organized teamwork for an early detection
and treatment of DDH has given impressive results. Coordinated work of
obstetricians, pediatricians-neonatologists, radiologists and children's
surgeons-orthopedists has led to the early diagnosis and treatment of DDH,
leading to the exclusion of surgery as a method of treatment.
Key words: Developmental hip dysplasia, early diagnosis, epidemiology,
ultrasound, treatment
RANA DIJAGNOZA RAZVOJNOG POREMEĆAJA KUKA
U OKRUGU PIROT
Kratak sadržaj: Razvojni poremećaj kuka (RPK) predstavlja značajan
medicinski problem, dovodeći kod nelečene dece do trajne invalidnosti.
Troškovi lečenja, hirurškog tretmana i rehabilitacije ove dece su mnogo
veći od relativno jednostavne prevencije. Ultrazvučni metod skrininga,
prema Grafu, omogućuje ranu dijagnozu i lečenje RPK. Cilj ovog rada bio
je da se analizira rana dijagnoza i prevencija RPK u okrugu Pirot. Analizirani
su sledeći vremenski periodi: 1) od 1985. do 1988. godine, kada je dijagnoza
RPK postavljana na osnovu kliničkog pregleda i radiološkog pregleda kukova
u šestom mesecu života deteta; 2) od 1989. do 1999. godine, kada je dijagnoza
RPK postavljana na osnovu kliničkog pregleda i ultrazvučnog nalaza na kukovima,
i to od 1989. do 1992. u četvrtom/petom mesecu, a od 1993. do 1999. u trećem
mesecu života. Ultrazvučni skrining kukova od 1989. do 1992. otkrio je
RPK kod 0,88% dečaka i 2,49% devojčica. Skrining u trećem mesecu života,
od 1993. do 1998, otkrio je RPK kod 0,21% dečaka i 1,35% devojčica, značajno
manje nego u prethodnom periodu. Lečenje RPK se preporučuje u prvih šest
nedelja ili bar u trećem mesecu života. Organizovani timski rad za rano
otkrivanje i lečenje RPK dao je impresivne rezultate. Koordinacija rada
akušera, pedijatra-neonatologa, radiologa i dečjeg hirurga-ortopeda omogućla
je da se hirurgija ne primenjuje kao metod lečenja RPK.
Ključne reči: Razvojni poremećaj kuka, rana dijagnoza, epidemiologija,
ultrazvuk, terapija
