Developmental dysplasia of the hip: real world data from a retrospective analysis to evaluate the effectiveness of universal screening

Abstract

Aims Developmental dysplasia of the hip is an important cause of disability in children and young adult and it also has a significant socio-economic impact in our society. The main objective of our study is to evaluate, in our hospital, the effectiveness of a universal ultrasound screening protocol and to assess the general knowledge about the theme of pediatricians and neonatologists. Methods Retrospective study of infants born from January 2016 to April 2019, evaluated with hip ultrasound (Graf method). Risk factors assessed were female gender, breech presentation at birth, positive family history and twin birth. For the secondary objective, an anonymous and validated questionnaire was distributed to all pediatricians and neonatologists. Results Among the 4000 hips analyzed, on ultrasound examination, 98.8% hips resulted mature or immature but appropriate for age, while 1,2% hips were pathological. Analyzing the mature or immature hips, 2,4% were positive on clinical examination and 97,6% were negative. In relation to ultrasound pathological hips, 33,3% have positive clinical examination, while 66,7% negative. From the analysis of risk factors a significant association emerged between female sex, breech presentation and family history with the ultrasound pathological findings. The results of Survey showed that inadequate training about developmental dysplasia of the hip is done during medical school. Conclusions A universal ultrasound screening allowed us to identify developmental dysplasia of the hip in a number of children with normal clinical examination and no risk factors. Specific training courses should be implemented regarding Developmental Dysplasia of the Hip for neonatologists and pediatricians.

Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy

“…Our initial search retrieved 1899 results, and we assessed 203 full texts. Ultimately, 76 studies 1 , 4 , 5 , 6 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , …”

“…A total of 60 studies 1 , 4 , 5 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 including 8 670 492 newborns assessed the incidence of early-detected DDH. Of these, 10 studies…”

Does the COVID‐19 pandemic cause late diagnosis and delay in treatment in developmental dysplasia of hip patients?

“…To best our knowledge, our study is the first study on this subject, and only one patient was reported in the literature. 18 But we believe that the number will increase as studies are carried out on this subject and that we will see this indirect effect of COVID 19.…”

Impact of the coronavirus disease 2019 pandemic on ultrasound screening of developmental dysplasia of the hip and follow-up imaging: a report from southeastern Turkey

“…5 Some centers routinely perform US screening in the first weeks of life to start treatment as early as possible, whereas others extend the period up to 6 months of age. [6][7][8][9] Early US screening can lead to a high incidence of false-positive results and unnecessary follow-up examinations, and screening at later than 3 months reduces the accuracy of the US examination and can lead to a delay in the proper treatment. 6 Because the prognosis of DDH is highly correlated with the time of diagnosis, early screening is important.…”