{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T14:22:32Z","timestamp":1769523752762,"version":"3.49.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>The aim of this study was to investigate the relationship of developmental dysplasia of the hip (DDH) with asymmetrical skin crease (ASC) in the inguinal, gluteal and thigh regions and to determine which ASC has the most predictive value for the diagnosis of hip dislocation in infants. This study was planned as a prospective, observational study and conducted between 1 October 2020 and 1 June 2021. Asymmetric distribution of skin creases was evaluated separately in three regions (inguinal, gluteal and thigh). Then, hip ultrasonography (USG) was performed and the Graf method was used to classify the cases as \u2018centralized\u2019 [Graf types I, IIa (-), IIb and IIc] and \u2018decentralized\u2019 (Graf types IId, III and IV). The relationship between the groups was evaluated using univariate and then multivariate analyses. A total of 241 patients were included in the study. The number of patients with ASC was 49 (21%). While 36 of these 49 patients had centralized hips, 13 had decentralized hips (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001). Sixty-five percent (13\/20) of 20 infants with decentralized hips had ASC in at least one of the inguinal, gluteal or thigh regions. The presence of ASC in the inguinal (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001) and gluteal (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.014) regions increased the risk of the decentralized hip in the child, whereas the presence of ASC in the isolated thigh region did not increase the risk of the dislocated hip (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.534). Inguinal ASC and gluteal ASC are reliable findings in DDH screening, but the relationship of isolated thigh ASC with DDH could not be demonstrated statistically. Level of Evidence: Level II \u2013 diagnostic study.<\/jats:p>","DOI":"10.1097\/bpb.0000000000000956","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T08:11:54Z","timestamp":1643703114000},"page":"517-523","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Multivariate analysis of the predictive value of asymmetric skin creases in diagnosis of decentralized developmental dysplasia of the hip"],"prefix":"10.1097","volume":"31","author":[{"given":"Ahmet","family":"Sevencan","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanifi","family":"Ucpunar","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman Nuri","family":"Ozyalvac","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evren","family":"Akpinar","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avni Ilhan","family":"Bayhan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timur","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"key":"R1-20250526","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/01241398-199003000-00001","article-title":"Results of newborn screening for CDH with and without sonography and correlation of risk factors.","volume":"10","author":"T\u00f6nnis","year":"1990","journal-title":"J Pediatr Orthop"},{"issue":"4 Pt 1","key":"R2-20250526","first-page":"896","article-title":"Committee on quality improvement, subcommittee on developmental dysplasia of the hip. 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