Abstract
The objective of this systematic literature review was to assess the incidence of DDH among the Saudi Arabian population. Methods: A systematic review was performed for all the published articles in the English language literature on DDH in Saudi Arabia. Data sources were PubMed Medline (1980-2018) (http://www.ncbi.nlm.nih.gov/pubmed/), Ovid Medline (1980-2018), EMBASE MEDLINE (1980 to May 2018), EMBASE (1991 to May 2018), the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, the Science Citation Index (1966 to May 2018), published data from the Saudi Medical Journal (1985-2018) and Annals of Saudi Medicine (1985-2018). The author independently reviewed articles and abstracted the data. The key words used were Saudi Arabia developmental dysplasia of the hip ORDDH, congenital hip dislocation or congenital subluxation of the hip, and congenital dysplasia of the hip. Results: The authors identified 18 potentially relevant articles published in the last 38 years, and 10 met the inclusion criteria. The 10 studies analyzed included 2037 studies of infants diagnosed with DDH; and they gave an average incidence of 10.46/1000. Two studies (303 subjects) did not report the affected gender; in the remaining 338 were boys and 1396 were girls and one study did not report the side of affection. The majority presented after 12 months of age. The right side was affected in 532 (27.2%) affected, 734 (37.6%) were left side and 687 (35.2%) infants were affected bilaterally. Consanguinity, breech presentation, and family history were found to be the risk factors in 32.9%, 17.3%, and 23.6% of the patients, respectively. Conclusions: There is paucity of available literature on DDH in Saudi Arabia. New strategies have to be developed that include mandatory screening programs in all hospitals (private and public) so that more children can be treated by nonsurgical methods.
Highlights
Development dysplasia of the hip (DDH) describes the entire array of deformities from subluxation and instability, frank dislocation, and dysplasia of the femoral head and acetabulum [1] [2] [3]
The objective of this systematic literature review was to assess the incidence of DDH among the Saudi Arabian population
The incidence of DDH varies in different countries, from dislocated hip at birth (1 - 5 per 1000 live births) to subluxation and dysplasia (10 per 1000) [4] [5] [6]
Summary
Development dysplasia of the hip (DDH) describes the entire array of deformities from subluxation and instability, frank dislocation, and dysplasia of the femoral head and acetabulum [1] [2] [3]. Diagnosis and appropriate treatment are important in providing children with hips that are as normal as possible. Many risk factors for DDH have been identified, such as swaddling [7] [8], consanguineous marriage [9] [10], and breech delivery [11] [12] [13] (the first two being under control of the parents). The epidemiology of any disease is important to find the incidence and risk factors and implement preventive measures so that early diagnosis and treatment could lead to a reduction in heightened morbidity in later life. DDH is common in Saudi Arabian children, and swaddling and consanguineous marriage still remain high
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