Berivan Ibrahim Jamal’s scientific contributions

Objectives: To show the vital role of dynamic ultrasound in hip instability screening and review the management plans available for DDH associated with instability with a view to reduce the incidence of complication from delayed diagnosis in our region. Place and Duration of the study: Helena governmental rehabilitation center for children with special needs, Erbil-Iraq, between Nov’21 to Jan’23. Material and Method: This study included 942 infants’ hips presenting with high-risk indicators or a positive clinical examination ranging in age from 6 weeks to 6 months. We performed the ultrasonography using the static Graf technique to determine the DDH Types and then apply the dynamic scan to find stability using Moren-Terjesen’s and Harcke methods. The management approaches were conducted considering both techniques. We used SPSS version 28 along with Chi-square test for data analysis and comparison of proportions. Results: In this retrospective cross-sectional study of 942 hips, the mean age of the infants was 11.9±4.8 weeks with male to female percentage of 46% to 54%. We found a correlation between family history and breech presentation to the dynamic scan stability. In the Graf technique 55% showed the absence of dysplasia while the dynamic scan showed 66% of the hips as normal and 34% as unstable. Further, the significant statistical association (P= 0.001) between the results of dynamic scan stability to the effect on the management plan was also found to advise the change for the unstable hips. Conclusion: It is crucial to apply both static and dynamic scans in the screening of DDH, so that we can reduce the possibility of late detection and elevate the level of diagnostic accuracy. We should follow a strict guideline for the management of all DDH cases (stable and unstable) and change the plan accordingly.

Purpose: Developmental dysplasia of the hip (DDH) comprises a spectrum of abnormalities from hip instability to frank dislocation, Hip ultrasonography prior to femoral head ossification, is recognized as an early diagnostic tool for DDH. It is safe and non-invasive procedure, keeping those babies less than 6 months of age away from radiation hazard. Subjects and Methods: From august 2021 until august 2022, we investigated 534 babies [1068 hips] by ultrasound depending on Graf method to identify DDH types. All included infants were in between 6 weeks- 6 months of age and referred due to have high risk factors. The data was analyzed by using the SPSS, version 28 and Chi- square test of association was used to compare the proportions. Results: On the bases of examining 534 babies [with high-risk groups] by ultrasound of hip, about 50.94 % of them were shown to have different types of DDH while 48.06% were normal, bilateral cases were > unilateral cases and Lt. hip >Rt. Hip were affected. Significant association was found between DDH family history (86%), breech presentation (52%)and swaddling (12%). Conclusions: It is crucial to establish the principle of selected screening programs for early detection of DDH in our society and to identify the incidence and associated risk factors for DDH in high-risk group babies between the ages of six weeks and six months in Erbil city of Kurdistan region-Iraq.