http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063216/
De:
ISRN Orthop. 2011; 2011: 238607.
Published online Oct 10, 2011. doi: 10.5402/2011/238607
PMCID: PMC4063216
The Epidemiology and Demographics of Hip Dysplasia
Abstract
The etiology of developmental dysplasia of the hip (DDH) is unknown. There are many insights, however, from epidemiologic/demographic information. A systematic medical literature review regarding DDH was performed. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%). The incidence per 1000 live births ranges from 0.06 in Africans in Africa to 76.1 in Native Americans. There is significant variability in incidence within each racial group by geographic location. The incidence of clinical neonatal hip instability at birth ranges from 0.4 in Africans to 61.7 in Polish Caucasians. Predictors of DDH are breech presentation, positive family history, and gender (female). Children born premature, with low birth weights, or to multifetal pregnancies are somewhat protected from DDH. Certain HLA A, B, and D types demonstrate an increase in DDH. Chromosome 17q21 is strongly associated with DDH. Ligamentous laxity and abnormalities in collagen metabolism, estrogen metabolism, and pregnancy-associated pelvic instability are well-described associations with DDH. Many studies demonstrate an increase of DDH in the winter, both in the northern and southern hemispheres. Swaddling is strongly associated with DDH. Amniocentesis, premature labor, and massive radiation exposure may increase the risk of DDH. Associated conditions are congenital muscular torticollis and congenital foot deformities. The opposite hip is frequently abnormal when using rigorous radiographic assessments. The role of acetabular dysplasia and adult hip osteoarthritis is complex. Archeological studies demonstrate that the epidemiology of DDH may be changing.
The etiology of developmental dysplasia of the hip (DDH) is unknown. There are many insights, however, from epidemiologic/demographic information. A systematic medical literature review regarding DDH was performed. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%). The incidence per 1000 live births ranges from 0.06 in Africans in Africa to 76.1 in Native Americans. There is significant variability in incidence within each racial group by geographic location. The incidence of clinical neonatal hip instability at birth ranges from 0.4 in Africans to 61.7 in Polish Caucasians. Predictors of DDH are breech presentation, positive family history, and gender (female). Children born premature, with low birth weights, or to multifetal pregnancies are somewhat protected from DDH. Certain HLA A, B, and D types demonstrate an increase in DDH. Chromosome 17q21 is strongly associated with DDH. Ligamentous laxity and abnormalities in collagen metabolism, estrogen metabolism, and pregnancy-associated pelvic instability are well-described associations with DDH. Many studies demonstrate an increase of DDH in the winter, both in the northern and southern hemispheres. Swaddling is strongly associated with DDH. Amniocentesis, premature labor, and massive radiation exposure may increase the risk of DDH. Associated conditions are congenital muscular torticollis and congenital foot deformities. The opposite hip is frequently abnormal when using rigorous radiographic assessments. The role of acetabular dysplasia and adult hip osteoarthritis is complex. Archeological studies demonstrate that the epidemiology of DDH may be changing.
Resumen
La etiología de la displasia del desarrollo de la cadera (DDC) es desconocida. Hay muchos puntos de vista, sin embargo, desde epidemiológica / información demográfica. Se realizó una revisión de la literatura médica sistemática con respecto a DDH. Hay un predominio del lado izquierdo (64,0%) y enfermedad unilateral (63,4%). La incidencia por cada 1.000 nacidos vivos oscila entre 0,06 en los africanos en África a 76,1 en los nativos americanos. Hay una variabilidad significativa en la incidencia dentro de cada grupo racial por ubicación geográfica. La incidencia de la clínica inestabilidad de cadera neonatal al nacer oscila entre 0,4 en los africanos a 61,7 en los caucásicos polacos. Los predictores de DDH son la presentación de nalgas, la historia familiar positiva, y el género (femenino). Los niños nacen prematuros, con bajo peso al nacer, o embarazos multifetales están algo protegidos de DDH. Ciertos tipos de HLA A, B, y D demuestran un aumento en la DDH. El cromosoma 17q21 se asocia fuertemente con DDH. La laxitud ligamentosa y anormalidades en el metabolismo del colágeno, el metabolismo de los estrógenos y la inestabilidad pélvica asociada al embarazo son asociaciones bien descritos con DDH. Muchos estudios demuestran un aumento de DDH en el invierno, tanto en los hemisferios norte y sur. Envolver está fuertemente asociado con DDH. La amniocentesis, parto prematuro, y la exposición masiva a la radiación pueden aumentar el riesgo de padecer esta enfermedad. Condiciones asociadas son tortícolis muscular congénita y deformidades de los pies congénitas. La cadera opuesta es con frecuencia anormal al utilizar las evaluaciones radiográficas rigurosos. El papel de la displasia acetabular y adultos artrosis de cadera es compleja. Los estudios arqueológicos demuestran que la epidemiología de DDH puede estar cambiando.
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