Screening for congenital dislocation of the hip by physiotherapists. Results of a ten-year study

Abstract

We report a prospective study of the feasibility of employing specially trained physiotherapists to screen neonates for congenital dislocation of the hip. During ten years 42,241 babies were screened, using clinical tests; 255 were diagnosed and treated by a Pavlik harness. In the same period 13 children presented late with congenital dislocation of the hip which had not been detected by the screening programme.

Developmental dysplasia of the hip: Risk markers, clinical screening and outcome

“…The rate in the present population was 0.63%, being higher in Jewish infants compared to Arab infants and without cases among infants of Ethiopian origin. These rates are within those reported from Israel as well as from several countries in Europe and in Australia 1,4,6,10–13 . Bialik et al reported in 1986 the results of neonatal clinical screening in Israel, and found a rate of 0.6 % for unstable hips 7 .…”

“…Evidence of a dislocatable hip was highly predictive for DDH, and 87% of dislocations were identified shortly after birth. This highlights the importance of clinical screening for these signs as part of routine well‐baby care starting from birth and through infancy 11,15,16 . Senaran et al found that unilateral limitation of hip abduction was a sensitive sign for developmental hip dysplasia 8 .…”

“…This highlights the importance of clinical screening for these signs as part of routine well-baby care starting from birth and through infancy. 11,15,16 Senaran et al found that unilateral limitation of hip abduction was a sensitive sign for developmental hip dysplasia. 8 Sahin et al assessed the validity of screening in 5798 infants during a 7 year period.…”

Developmental dysplasia of the hip: Controversies and current concepts

“…[43][44][45] In most maternity hospitals neonatal hip examinations are performed predominantly by paediatricians, or less commonly by orthopaedic surgeons. In order to be accurate and reliable, clinical examination of infant hips must be performed by experienced, trained personnel.…”

Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review for the US Preventive Services Task Force

“…64,65 Additional studies show that well-trained nonphysicians, including physiotherapists and neonatal nurse practitioners, perform at least as well as physician examiners and better than physician trainees. [66][67][68] In 1 single-site longitudinal study, as the number of pediatricians involved in screening infants increased (holding steady the overall number of newborns screened), a greater number of cases of DDH were missed despite an increased rate of suspected cases identified. 69 In other words, both sensitivity and specificity suffered when there was less centralized oversight of the newborn screening program and when fewer infants were screened, on average, by each pediatrician.…”