Background: 

The clinical finding of asymmetric skinfolds (ASF) in infants is used to indicate the possibility of developmental dysplasia of the hip (DDH). The association of ASF and a diagnosis of DDH remains unknown.

Purpose: 

To determine the association of ASF in the gluteal and femoral regions with a diagnosis of DDH.

Methods: 

The correlation of ASF and other physical examination findings with DDH was compared retrospectively. The medical records of infants who underwent DDH screening in the clinic were analyzed. The physical examination findings were reviewed and categorized as ASF, clunk of the hip, limb-length discrepancy, hip abduction limitation, combined conditions of musculoskeletal disorders, and regular screening for DDH. The hip conditions were classified by Graf's ultrasound method. Type IIb and higher classifications were defined as DDH. The diagnosed rate and severity of DDH based on physical examination findings were calculated and compared.

Results: 

Clinical data of 3266 infants aged up to 6 months were reviewed, and 194 infants were diagnosed with DDH by ultrasound examination. ASF was the most common indication for DDH screening (64.5%; 2107/3266). However, this was poorly correlated with a diagnosis of DDH (4.79%; P < .0001). No difference was found between the Graf classification severity and various indications (P = .079).

Implications for Practice: 

Clinicians should recognize that, although ASF is the most common reason for DDH screening in infants, ASF does not correlate with a diagnosis of DDH.

Implications for Research: 

Additional research should examine the relationship between DDH and ASF in other populations.

中文翻译：

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不对称皮褶与婴儿髋关节发育不良的诊断的关系

背景： 

婴儿不对称皮褶（ASF）的临床发现可用于提示发育性髋关节发育不良（DDH）的可能性。ASF 与 DDH 诊断之间的关联仍不清楚。

目的： 

确定臀肌和股骨区域 ASF 与 DDH 诊断的关联。

方法： 

回顾性比较ASF和其他体检结果与DDH的相关性。对在诊所接受 DDH 筛查的婴儿的医疗记录进行了分析。对体检结果进行审查并分类为 ASF、髋部笨重、肢体长度差异、髋部外展受限、肌肉骨骼疾病的综合病症以及定期筛查 DDH。通过格拉夫超声法对髋部状况进行分类。IIb 型及更高分类被定义为 DDH。计算并比较根据体检结果得出的DDH的诊断率和严重程度。

结果： 

回顾了3266名6个月以下婴儿的临床资料，其中194名婴儿经超声检查诊断为DDH。ASF 是 DDH 筛查最常见的指征 (64.5%; 2107/3266)。然而，这与 DDH 的诊断相关性较差 (4.79%；P < .0001)。Graf 分类严重程度和各种适应症之间没有发现差异 ( P = .079)。

对实践的启示： 

临床医生应该认识到，尽管 ASF 是婴儿 DDH 筛查的最常见原因，但 ASF 与 DDH 的诊断并不相关。

对研究的影响： 

额外的研究应该检查其他人群中 DDH 和 ASF 之间的关系。