{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:29:07Z","timestamp":1788535747856,"version":"build-2803163510"},"reference-count":14,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objectives: The objective of this study was to compare outcomes of universal versus female-inclusive selective ultrasonography screening for developmental dysplasia of the hip (DDH) in a neonatal population. Methods: This prospective cohort study evaluated two consecutive screening strategies at a single institution: a universal ultrasonography program (2019\u20132020; n = 354) and a selective program (2024\u20132025; n = 290). The selective protocol included all female neonates, breech presentation, positive family history, or abnormal clinical findings. All examinations were performed by the same operator using the Graf method. The primary outcome was detection of dysplastic hips; secondary outcomes included immature hip distribution, subgroup differences, and screening efficiency. Results: DDH detection rates were identical between cohorts (1.7%). In the universal cohort, six infants had dysplastic hips; in the selective cohort, five infants were affected, all females. Among these, 40% had no major risk factors. The proportions of mature and immature hips were comparable between cohorts. Screening efficiency was similar (number needed to screen: 59 vs. 58), despite a substantially reduced number of scans in the selective program. Conclusions: A selective screening program that includes all female neonates achieved DDH detection rates comparable to universal screening while significantly reducing imaging volume. As all dysplastic cases occurred in girls, this female-inclusive approach captured the highest-risk demographic without relying solely on traditional risk factors. Incorporating sex-based eligibility into selective screening may provide a safe and efficient framework for DDH screening programs in diverse clinical settings.<\/jats:p>","DOI":"10.3390\/children13091195","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:09:29Z","timestamp":1788534569000},"page":"1195","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Female-Inclusive Selective Versus Universal Neonatal Hip Ultrasonography Screening for Developmental Dysplasia of the Hip"],"prefix":"10.3390","volume":"13","author":[{"given":"Nina","family":"\u0110or\u0111evi\u0107","sequence":"first","affiliation":[{"name":"Orthopedic Department, Mediclinic Al Jowhara Hospital, Al Ain P.O. Box 14444, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Sridhar","family":"Kalyanasundaram","sequence":"additional","affiliation":[{"name":"Pediatric Department, Mediclinic Al Jowhara Hospital, Al Ain P.O. Box 14444, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/BPO.0000000000000704","article-title":"The fate of the iliopsoas muscle in long-term follow-up after open reduction with a medial approach in developmental dysplasia of the hip. Part 2: Isokinetic muscle strength evaluation","volume":"37","author":"Yilmaz","year":"2017","journal-title":"J. Pediatr. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/BPO.0000000000002234","article-title":"Redislocation after posteromedial open reduction in developmental dysplasia of the hip: Analyzing the risk factors and determining the optimal treatment method","volume":"42","author":"Gencer","year":"2022","journal-title":"J. Pediatr. Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.aott.2019.05.004","article-title":"Evaluation of cartilage coverage with magnetic resonance imaging in residual dysplasia and its impact on surgical timing","volume":"53","author":"Caliskan","year":"2019","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e2227638","DOI":"10.1001\/jamanetworkopen.2022.27638","article-title":"Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy: A Systematic Review and Meta-Analysis","volume":"5","author":"Kuitunen","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Han, J., and Li, Y. (2022). Progress in screening strategies for neonatal developmental dysplasia of the hip. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.995949"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1007\/s00247-023-05666-x","article-title":"The effect of selective ultrasound screening on the incidence of late presentation of developmental hip dysplasia\u2014A meta-analysis","volume":"53","author":"Laborie","year":"2023","journal-title":"Pediatr. 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Disord., 21.","DOI":"10.1186\/s12891-020-03454-4"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.15537\/smj.2023.44.11.20230444","article-title":"Universal in-house neonatal hips ultrasonography screening in the United Arab Emirates","volume":"44","year":"2023","journal-title":"Saudi Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Lankinen, V., Helminen, M., Bakti, K., V\u00e4lipakka, J., Laivuori, H., and Hyv\u00e4rinen, A. (2023). Known risk factors of developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment. BMC Pediatr., 23.","DOI":"10.1186\/s12887-023-03935-0"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.15537\/1658-3175.2196","article-title":"The pattern of developmental dysplasia of the hip in Saudi Arabia","volume":"24","author":"Kremli","year":"2003","journal-title":"Saudi Med. J."},{"key":"ref_13","first-page":"1","article-title":"Developmental dysplasia of the hip in the Eastern Province of Saudi Arabia: Incidence and risk factors","volume":"10","year":"2020","journal-title":"Open J. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.aott.2019.05.001","article-title":"Is male gender a prognostic factor for developmental dysplasia of the hip? Mid- to long-term results of posteromedial limited surgery","volume":"53","author":"Caliskan","year":"2019","journal-title":"Acta Orthop. Traumatol. Turc."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1195\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:10:28Z","timestamp":1788534628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":14,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["children13091195"],"URL":"https:\/\/doi.org\/10.3390\/children13091195","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}