Document Type : original article


Division of Neonatology, Hirslanden Clinic Witellikerstrasse 40 CH-8032 Zürich, Switzerland




The purpose of this retrospective study was to check sonographic hip types according Graf technique in Large for gestational age (GA) babies and compare the results with normal and small for gestational age babies, in different groups and to investigate the influence of birthweight on the incidence of developmental dysplasia of the hip (DDH).


Between 1993 and 2003 Ultrasonography (US) of the hips was performed in 7417 consecutive newborns at 34-42 Weeks gestation using the Graf method during the first week of life.

US showed pathological findings in 168 hips (2.3%), 139 were girls (82.7%) and 29 were boys (17.3%). According to Graf types there were 63 type IIc, 56 type D, 46 type III, and 3 type IV hips.

Except for one boy (type III) all were successfully treated by conservative orthopaedic methods.


Overweight which was defined as large for gestational age (GA) in association with breech

presentation showed the highest risk for pathological hips requiring treatment (15.6%), followed by normal weight and breech presentation (7.6%), and large for gestational age newborns at term (5%).

The lowest percentage of newborns in need of subsequent orthopaedic treatment was in 66 small for GA with breech presentation (1.5%). There were no association with developmental dysplasia of the hip (DDH) in 230 small for GA newborns at term, and in 174 twins.


The results according the sonographic types suggest that high birth weight is a major risk factor of DDH, especially when combined with breech presentation and, an almost 5:1 female preponderance