Epidemiology is the study of the incidence, distribution, and determinants of disease frequency in groups of individuals who happen to have characteristics in common (e.g., gender, ethnicity, exposure, genetics). Archeological studies demonstrate that the epidemiology of DDH may be changing.ĭemography is the study of human populations with reference to size, diversity, growth, age, and other characterizing statistics. The role of acetabular dysplasia and adult hip osteoarthritis is complex. The opposite hip is frequently abnormal when using rigorous radiographic assessments. Associated conditions are congenital muscular torticollis and congenital foot deformities. Amniocentesis, premature labor, and massive radiation exposure may increase the risk of DDH. Swaddling is strongly associated with DDH. Many studies demonstrate an increase of DDH in the winter, both in the northern and southern hemispheres. Ligamentous laxity and abnormalities in collagen metabolism, estrogen metabolism, and pregnancy-associated pelvic instability are well-described associations with DDH. Chromosome 17q21 is strongly associated with DDH. Certain HLA A, B, and D types demonstrate an increase in DDH. Children born premature, with low birth weights, or to multifetal pregnancies are somewhat protected from DDH. Predictors of DDH are breech presentation, positive family history, and gender (female). The incidence of clinical neonatal hip instability at birth ranges from 0.4 in Africans to 61.7 in Polish Caucasians. There is significant variability in incidence within each racial group by geographic location. The incidence per 1000 live births ranges from 0.06 in Africans in Africa to 76.1 in Native Americans. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%). A systematic medical literature review regarding DDH was performed. There are many insights, however, from epidemiologic/demographic information. The etiology of developmental dysplasia of the hip (DDH) is unknown.
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