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Published on: June 29, 2013
The effect of selective ultrasound screening on late presenting DDH
M Zenios1, B Wilson, C S Galasko
1Department of Orthopaedic Surgery, University of Manchester, Hope Hospital, Stott Lane, Salford, M6 8HD, UK.
Insights
Selective ultrasound screening did not reduce late Developmental Dysplasia of the Hip (DDH) cases. A broader screening program for babies with DDH risk factors is recommended to prevent late presentations.
Area of Science:
- Pediatric Orthopedics
- Diagnostic Imaging
Background:
- Developmental Dysplasia of the Hip (DDH) can lead to long-term complications if not identified early.
- Selective screening protocols have been implemented to detect DDH, but their effectiveness in reducing late presentations requires evaluation.
Purpose of the Study:
- To assess the impact of a selective ultrasound screening program on the incidence of late-presenting Developmental Dysplasia of the Hip (DDH).
Main Methods:
- A cohort study examining babies born between 1991-1995 in the Salford area.
- Babies with suspected hip instability or known DDH risk factors were referred for sonographic hip examination.
- Treatment decisions were based on ultrasound findings.
Main Results:
- Nineteen infants with clinically normal hips on examination had sonographically abnormal hips and were successfully treated with abduction splints.
- The incidence of late-presenting DDH did not decrease compared to previous cohorts.
- No late-presenting DDH cases were referred for postnatal sonographic examination.
Conclusions:
- Selective ultrasound screening alone was insufficient to reduce late-presenting DDH.
- A comprehensive ultrasound screening program for all infants with DDH risk factors is advised.
- Early detection through widespread screening is crucial for preventing late DDH presentations.
Abstract:
We examined the impact of selective ultrasound screening on late presenting Developmental Dysplasia of the Hip (DDH) in the Salford area. In the years 1991-1995, babies with suspected clinical hip instability and a number of babies with known risk factors for DDH were referred to a designated Baby Hip clinic for sonographic hip examination. The decision for treatment was based solely on ultrasound findings. We found that nineteen babies reported as having a clinically normal hip by a Senior Registrar in Orthopaedics had sonographically abnormal hips and were treated successfully with an abduction splint. The incidence of late presenting DDH was not reduced when compared with two previous cohorts born at the same centre. None of the children that presented with a late DDH was referred for a sonographic examination after birth. A more widespread ultrasound screening programme including all babies with risk factors for DDH is advised in order to reduce late presentations.
