HipMultivariate analysis of the predictive value of asymmetric skin creases in diagnosis of decentralized developmental dysplasia of the hipSevencan, Ahmet; Ucpunar, Hanifi; Ozyalvac, Osman Nuri; Akpinar, Evren; Bayhan, Avni Ilhan; Yildirim, Timur Author Information Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey Received 6 October 2021 Accepted 8 January 2022 Correspondence to Ahmet Sevencan, Department of Orthopaedic Surgery and Traumatology, Baltalimani Bone Diseases Training and Research Center, Rumeli Hisari Cad., Baltalimani, Sariyer, Istanbul, Turkey, Tel: +90 532 720 61 94; fax: +90 212 323 70 82; e-mail: [email protected] Journal of Pediatric Orthopaedics B: November 2022 - Volume 31 - Issue 6 - p 517-523 doi: 10.1097/BPB.0000000000000956 Buy Metrics Abstract 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 ‘centralized’ [Graf types I, IIa (-), IIb and IIc] and ‘decentralized’ (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 (P < 0.001). 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 (P < 0.001) and gluteal (P < 0.014) 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 (P = 0.534). 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 – diagnostic study. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.