Thomas Baumann
Stefan Essig- 1Independent Researcher, Solothurn, Switzerland
- 2Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
Editorial on the Research Topic
Developmental dysplasia of the hip in children: The role of early diagnosis and treatment
Developmental dysplasia of the hip (DDH) is one of newborns’ most common causes of musculoskeletal health conditions. Our Research Topic, “Developmental Dysplasia of the Hip in Children: The Role of Early Diagnosis and Treatment”, provides insight into DDH diagnosis and treatment aspects.
A diagnosis of DDH in the first weeks of life should be made by ultrasound. Graf established ultrasound examinations of the hip of the newborn (1), but other authors such as Harcke (2), Terjesen (3), Suzuki (4) and Morin (5) have also promoted ultrasound methods. In addition, there are adaptations of the Graf system by Rosendahl (6) and Baumann (7). The most widely used way is that of Graf. However, the problematic comparability of results between the diverse methods has severely hampered its dissemination. Ossendorff et al. describe in their article user errors and insufficient application of the Graf quality assessment algorithm as other causes. Furthermore, as Walter et al. report, the quality of published articles on hip examinations that follow the Graf approach is often insufficient. Therefore, the discussion about the reliability of diagnostic methods rightly continues. One question that is also intensely debated in this context is whether a general screening or an examination according to risk or clinical findings is beneficial. Here, the work of Han and Li presents an argumentative basis for a universal ultrasound screening to prevent late-detected cases.
There are many uncertainties not only in diagnostics but also in therapy. Although many authors assume that treatment should start as early as possible, there are still significant differences of opinion on the “how” (8). Studies show a largely “eminence-based” rather than “evidence-based” approach. Thus, conservative as well as surgical procedures are used. There has yet to be an international consensus to optimise and simplify the therapy according to scientific aspects. The paper by Chaibi et al. concerns the issue of the reliability of the Tübingen splint as a treatment option for unstable hips. Gou et al. have presented an interesting paper regarding the use of the Pavlik harness.
In our Research Topic, insightful papers could be published quickly. We hope to see more publications that shed light on the early diagnosis and therapy of DDH to optimise its management and improve the prognosis for the affected children.
Author contributions
All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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References
1. Graf R. Sonographie der Säuglingshüfte und therapeutische Konsequenzen. Stuttgart, Germany: Thieme Verlag Stuttgart (2010).
2. Harcke HT, Grissom LE. Performing dynamic sonography of the infant hip. Am J Roentgenol. (1990) 155:837–44. doi: 10.2214/ajr.155.4.2119119
3. Terjesen T, Bredland T, Berg V. Ultrasound for hip assessment in the newborn. J Bone Joint Surg Br. (1989) 71(5):767–73. doi: 10.1302/0301-620X.71B5.2684989
4. Suzuki S, Kasahara Y, Futami T, Ushikubo S, Tsuchiya T. Ultrasonography in congenital dislocation of the hip. Simultaneous imaging of both hips from in front. J Bone Joint Surg Br. (1991) 73(6):879–83. doi: 10.1302/0301-620X.73B6.1955428
5. Morin C, Harcke HT, MacEwen GD. The infant hip: real-time US assessment of acetabular development. Radiology. (1985) 157(3):673–7. doi: 10.1148/radiology.157.3.3903854
6. Rosendahl K, Markestad T, Lie RT. Ultrasound in the early diagnosis of congenital dislocation of the hip: the significance of hip stability versus acetabular morphology. Pediatr Radiol. (1992) 22(6):430–3. doi: 10.1007/BF02013504
7. Baumann T, Schmid R, Essig S. Update Hüftreifestörung-Diagnostik und Behandlung. Pädiatrie Up2date. (2017) 12(4):375–93. doi: 10.1055/s-0043-114855
Keywords: newborn, hip ultrasound, orthosis, surgery, developmental dysplasia of the hip (DDH)
Citation: Baumann T and Essig S (2023) Editorial: Developmental dysplasia of the hip in children: The role of early diagnosis and treatment. Front. Pediatr. 11:1138999. doi: 10.3389/fped.2023.1138999
Received: 6 January 2023; Accepted: 17 January 2023;
Published: 3 February 2023.
Edited and Reviewed by: Federico Canavese, Centre Hospitalier Regional et Universitaire de Lille, France
© 2023 Baumann and Essig. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Thomas Baumann thom.baum@bluewin.ch; Stefan Essig stefan.essig@unilu.ch
Specialty Section: This article was submitted to Pediatric Orthopedics, a section of the journal Frontiers in Pediatrics