The Incidence, Diagnosis, and Treatment practices of Developmental Dysplasia of Hip (DDH) in India: A Scoping Systematic Review

Chand, Suresh; Aroojis, Alaric; Pandey, Ritesh Arvind; Johari, Ashok

doi:10.1007/s43465-021-00526-y

Cited by 13 publications

(10 citation statements)

References 40 publications

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“…Since there is a lot of variability in the provision of care pathways many centres have diagnosed late cases of DDH. 19 Likewise, malignancies such as sarcomas mainly present in the paediatric population. Several specialists are needed for correct management.…”

Section: Examples In Existing Literaturementioning

confidence: 99%

Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

Sinha,

Rai

2024

IJOS

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For the duration of my medical elective, I was placed in a government hospital by the name of Loknayak Jai Prakash Narayan Hospital. It specialises in trauma and orthopaedics, and is one of four government hospitals in Patna- the state capital of Bihar. My supervisor subspecialises in the hip and knee joint. Most patients belong to the lower socioeconomic classes and therefore rely on free delivery of care. During this essay I will reflect upon my firsthand experiences, as well as explore the existing literature, to highlight the importance of integrated care. Orthopaedics is a speciality that brings together many diverse groups of healthcare professionals. The NHS has always placed a strong emphasis on continuity of care by designing standardised frameworks. Coming from an alternative perspective, I seek to observe whether patients and healthcare professionals in Bihar also understand the concept of integrated care. Using examples I will look back to see how various teams work together within the Indian secondary care context.

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Section: Examples In Existing Literaturementioning

confidence: 99%

Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

Sinha,

Rai

2024

IJOS

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“…An association of DDH has been described with congenital muscular torticollis, metatarsus adductus, and talipes equinovarus. [1][2][3] All neonates must be screened at birth for DDH by a clinical examination followed by continued surveillance for DDH till 18 months of age. 3,4 When the DDH is diagnosed and treated well in time during infancy, conservative management is often successful with good long-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

Newborn Screening for Developmental Dysplasia of Hip—A Survey for Knowledge and Skills Among Physicians in Delhi-NCR Region, India

Prasad,

Gupta,

Parashar

et al. 2023

Journal of Neonatology

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Introduction Developmental dysplasia of hip (DDH) is a developmental disorder leading to life-long disability in child unless diagnosed early and treated well in time. This condition is also included under the screening and early intervention services provided by “Rashtriya Bal Swasthya Karyakram” of National Health Mission in India. The present study was done to assess knowledge, perceptions, and self-confidence of pediatricians/neonatologists, obstetricians, primary care physicians (PCPs), and the orthopedic surgeons regarding the newborn screening for DDH. Materials and Methods This cross-sectional study used a prestructured validated online questionnaire in English language. Total 158 physicians, practicing in various private and government, teaching, and nonteaching institutions from Delhi-NCR region (54 pediatrician/neonatologists, 60 PCPs, 30 orthopedic surgeons, and 14 obstetricians), responded to the survey. Questions related to biodemographic details, specialty, professional experience, knowledge about the risk factors of DDH, appropriate timing(s) for screening DDH and the modalities used, and natural course of untreated severe and mild DDH were asked. Participants were required to self-assign a grade (score 0-10) for both knowledge and clinical examination skills with reference to screening of DDH. Data was analyzed using SPSS (version 23.0) software. P value <0.05 was considered significant. Results Only 18% pediatricians, 27% PCPs, 20% orthopedic surgeons, and none of the obstetrician could identify all risk factors for DDH ( P = 0.159). Only 24% physicians knew that the natural evolution of untreated severe DDH is bad with need for multiple surgeries throughout life and only 17% knew that the most common natural evolution of untreated mild hip dysplasia at birth is good with minimal functional sequelae without the need for surgery. Only 56% pediatricians mentioned correctly that the first screening for DDH needs to be done at birth before discharge from the hospital. Orthopedic surgeons, obstetricians, and PCPs were comparable to pediatricians in this knowledge ( P ≥ 0.05). Only 52% pediatricians were aware of both Barlow and Ortolani clinical maneuvers and 18% did not know about any of these tests. Among orthopedic surgeons, 60% knew about both these tests and among obstetricians, only 14% knew about both these tests. Self-assigned score for both knowledge and clinical examination skills were unsatisfactory in all groups, the range of median score being 5 to 7 and 2 to 6, respectively. Clinical examination skills scores were significantly lower among obstetricians than the other groups ( P = 0.001; Kruskal-Wallis test). Clinical examination skills scores were significantly lower than the knowledge scores among PCPs, orthopedic surgeons, and obstetricians ( P = 0.001, 0.026, and 0.005, respectively; Wilcoxon Signed-Rank test). Conclusion Knowledge was unsatisfactory among all physicians, regardless of their specialty. Self-assigned scores for clinical examination skills, which is a surrogate of self-confidence and likely to affect the practices, were also unsatisfactory among all physicians, regardless of their specialty. The findings of this study indicate an immediate need of attention for continuing education and handholding of all stakeholders who are directly responsible for screening and early diagnosis of DDH at birth and early infancy. Such a pertinent issue should be incorporated as a core knowledge as well as skill competencies in both undergraduate and postgraduate medical education curriculum.

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“…The estimated incidence of developmental dysplasia of hip (DDH) in India is between 1 and 2.6/1000 live births [ 1 ]. With the lack of national hip surveillance program and inadequate health infrastructure in general, it is not uncommon to encounter walking age, neglected DDH in outpatient clinic in India.…”

Section: Introductionmentioning

confidence: 99%

Open Reduction with Femoral Shortening, Derotation Osteotomy, and Acetabuloplasty in a Walking Age Developmental Dysplasia of Hip – A Surgical Video Technique

Chand¹,

Srivastava²

2022

JOCR

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Introduction: It is very common for pediatric orthopedic surgeon to encounter developmental dysplasia of hip (DDH) in walking age, especially in developing countries. The conservative options of management are almost over by this age and most require open reduction (OR) with various adjunct procedures. The most preferred approach for OR in this age group is anterior Smith-Peterson approach to hip joint. These neglected cases also require femoral shortening ± derotation osteotomy and acetabuloplasty. Case Presentation: In this surgical video technique, we demonstrate OR + femoral shortening and derotation osteotomy and acetabuloplasty, step by step, in a neglected, walking age DDH in a 3-year-old child. We hope that the detailed demonstration and tricks at various surgical steps will benefit our readers and viewers. Conclusion: Step-wise surgical execution as per demonstrated technique makes the procedure easily reproducible with fairly good outcomes. In this case example, with demonstrated surgical technique, we were able to achieve a good outcome at short-term follow-up.

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The Incidence, Diagnosis, and Treatment practices of Developmental Dysplasia of Hip (DDH) in India: A Scoping Systematic Review

Cited by 13 publications

References 40 publications

Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

Newborn Screening for Developmental Dysplasia of Hip—A Survey for Knowledge and Skills Among Physicians in Delhi-NCR Region, India

Open Reduction with Femoral Shortening, Derotation Osteotomy, and Acetabuloplasty in a Walking Age Developmental Dysplasia of Hip – A Surgical Video Technique

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