Risk Factors for Developmental Dysplasia of the Hip: A Critical Analysis About an Unclear Relationship.

Results: The analyses revealed a significant protective role of the presence of other lower limb congenital malformations such as clubfoot, which was more closely associated with a stable form of DDH (OR = 0.26, p = 0.017), a significant association between the presence of mechanical risk factors in females with an unstable form of DDH (OR = 5.00, p = 0.042), a borderline significant protective role of breech presentation in females, which was more closely associated with a stable form of DDH (OR = 0.25, p = 0.054), and a borderline significant association between the presence of mechanical risk factors and an unstable form of DDH (OR = 4.28, p = 0.054).

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The increased rates of higher Graf grades were found to be of borderline significance for mechanical risk factors when considered for both sexes (OR = 4.28, p = 0.054) and significant when considering females only (OR = 5.00, p = 0.042).

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Possible Clinical Implications Considering our results as well as the limitations of our study, we would like to carefully highlight the lack of highly significant results regarding the identification of determinants of a more severe Graf grade, which, in our opinion, underscores the importance of a general screening program for developmental dysplasia of the hip.

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