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Late presentation of developmental dysplasia of the hip
1Department of Orthopaedic and Trauma Surgery, Cork University Hospital, Ireland. rehangul@hotmail.com
Insights
Despite neonatal screening for developmental dysplasia of the hip (DDH), late diagnoses persist. This study highlights low suspicion rates, indicating a need to re-evaluate screening effectiveness for DDH.
Area of Science:
- Pediatric Orthopedics
- Public Health Screening Programs
Background:
- A neonatal screening program for developmental dysplasia of the hip (DDH) is active in Cork.
- Despite screening, infants are still diagnosed with DDH at later ages, leading to significant morbidity and potential medicolegal issues.
Purpose of the Study:
- To investigate the reasons behind late presentations of DDH, even with an existing screening program.
Main Methods:
- A retrospective analysis of the inpatient database was conducted.
- All cases of late DDH diagnosed between 1988 and 2000 were identified.
Main Results:
- Forty-nine cases of DDH were diagnosed, with a mean age of 14.8 months (range 6-47 months).
- Multiple risk factors were present in only 14 patients, and more than two risk factors were identified in just four patients.
Conclusions:
- Late DDH diagnosis remains a concern despite current screening efforts.
- The low incidence of multiple risk factors in late-diagnosed cases suggests a potential under-suspicion in the patient group, necessitating a review of screening protocols.
Background:
A neonatal screening programme for developmental dysplasia of the hip (DDH) is ongoing in Cork. Despite early screening, infants continue to present at later ages with DDH. The impact of late diagnosis is significant. Established DDH causes significant morbidity and may have major medicolegal implications.
Aim:
To identify the reasons for the late presentation of DDH in the presence of a screening programme.
Methods:
In a retrospective study all cases of late DDH presenting from 1988 to 2000 were identified using inpatient database.
Results:
Forty-nine cases of DDH were diagnosed. The mean age of diagnosis was 14.8 months (range 6-47). Multiple risk factors were identified in four patients only. More than one risk factor was identified in 10 patients.
Conclusion:
Despite screening, children continue to present with late DDH. In this study, only 14 patients had multiple risk factors and only four patients had more than two risk factors, highlighting the low incidence of suspicion in this patient group.