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1).Acta Orthop Traumatol Turc. 2007;41 Suppl 1:6-13. Links
[The use of ultrasonography in developmental dysplasia of the hip]
[Article in Turkish]
Graf R.
Allgemeines und Orthopädisches Landeskrankenhaus Stolzalpe Stolzalpe, 8852 Stolzalpe, Austria. Adres poczty elektronicznej jest chroniony przed robotami spamującymi. W przeglądarce musi być włączona obsługa JavaScript, żeby go zobaczyć. Adres poczty elektronicznej jest chroniony przed robotami spamującymi. W przeglądarce musi być włączona obsługa JavaScript, żeby go zobaczyć.
Approach to hip sonography in Europe differs considerably from that in the USA, with different examination techniques and, therefore, discrepant results. The method used in Austria, Switzerland, Germany, and other countries is strictly standardized, reproducable, and out of the experience and skill of the examiner. Open reductions have been reduced to 0.13/1000 newborn babies in Austria, and to 0.26/1000 in Germany. This is the lowest rate which ever has been reported in the world. Costs for screening and treatment are three times lower than in the presonography era. These improvements result from training given by authorized teachers, implementation of ultrasonography screening program within the first six weeks of life, and planning treatment according to the sonography types.

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Progress in Prevention of Late Developmental Dislocation of the Hip by Sonographic Newborn Hip "Screening": Results of a Comparative Follow-up Study
Graf, R.; Tschauner, Chr.; Klapsch, W.
Journal of Pediatric Orthopaedics B. 2(2):115-121, 1993.
Graf , R . Graf , R . BY> R .


Abstract:
Summary: Effective prevention of late developmental dislocation of the hip (DDH) has become a reality because a safe diagnosis can be obtained as early as possible by using the original sonographic method of Graf. Correct sonographic diagnosis must be immediately followed by adequate and biomechanically rational and consistent therapeutic management and long-term follow-up. Results of a strictly comparative follow-up study underscore the enormous progress in the quality of therapeutic results obtained with a general sonographic newborn hip "screening" directly in the maternity ward: Successful anatomic healing by conservative treatment without femoral head necrosis, without operation, and without late DDH is consistently achieved and costs less when sonographic assessment is made in the first days of life.

For these reasons, the Austrian government has included sonographic neonatal hip screening in its general health prevention program and has reimbursed the cost of this preventive procedure since 1992.



2).Journal of Pediatric Orthopaedics:
Original Article: PDF Only
New Possibilities for the Diagnosis of Congenital Hip Joint Dislocation by Ultrasonography
Graf, R.

Abstract
Six hundred infant hips were examined with ultrasonography and the findings compared to radiography. Twelve hips were dislocated and could be recognized as such on the sonograms. The development of the acetabular roof can be determined through assessment of the preformed, nonosseous acetabular rim. Consequently, dysplasia of the hip can be recognized early. Ultrasonography does not replace clinical investigation, but it does reduce the need for radiography, reducing the exposure of the child to radiation.

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3).Fundamentals of Sonographic Diagnosis of Infant Hip Dysplasia
Graf, R
Journal of Pediatric Orthopaedics. 4(6):735-740, November 1984.
Graf , R Graf , R BY> R Graf
Summary: Since 1978 we have examined 3,500 infant hips by ultrasonography. We classified these hips into four basic categories: (a) normal, according to age; (b) delayed ossification (dysplasia); (c) partial dislocation (subluxation); and (d) dislocation (total luxation). Ultrasound provides no exposure to radiation and can differentiate soft tissue much better than radiography. It clearly offers a new tool for infant screening with the potential for widespread application.

 
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