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Neonatal hip instability in Saudi Arabia: Results and cost effectiveness
1Associate Professor and Chairman, Pediatric Department, King Faisal University, Al-Khobar, Saudi Arabia.
Insights
Screening newborns for congenital dislocation of the hip (CDH) is cost-effective. Early detection and intervention via screening programs prevent long-term issues and justify sustained efforts.
Area of Science:
- Orthopedics
- Pediatric Health
- Public Health Screening
Background:
- Congenital dislocation of the hip (CDH) screening benefits are established, but the necessity of treating all positive cases is debated.
- An 11-year screening program provides data on cost-effectiveness and management of CDH.
Purpose of the Study:
- To evaluate the cost-benefit of a long-term congenital dislocation of the hip screening program.
- To assess the effectiveness of early surgical intervention for CDH.
Main Methods:
- Screening 30,651 live births for CDH using Barlow and Ortolani maneuvers.
- Analyzing epidemiological and clinical data over an 11-year period.
- Evaluating the costs associated with screening and surgical management.
Main Results:
- An incidence of 4.3 per 1000 live births for CDH was observed.
- The study confirmed the cost-effectiveness of the screening program.
- Early intervention was crucial for cases not self-stabilizing.
Conclusions:
- The 11-year screening program for congenital dislocation of the hip is cost-effective and justifies continued implementation.
- Screening and early management of CDH significantly reduce human suffering and long-term healthcare costs.
- Sustained screening programs are essential for managing CDH effectively.
Abstract:
The benefits of screening hips at birth for congenital dislocation have been repeatedly confirmed but doubts have been raised about the need for splinting all positive cases. Experience from an ongoing screening program, now in operation for over 11 years, is presented particularly with reference to cost benefit of screening and early surgical intervention. Of 30,651 live born babies screened for congenital dislocation of the hip (CDH) employing Barlow and Ortolani maneuvers, 132 were found to be positive, giving an incidence of two to six per 1000 liver births, averaging 4.3/1000 for the period. The implications of epidemiologic and clinical observations and of management have been discussed. The cost of screening and of surgical management of cases that would not have stabilized without intervention. Cost effectiveness of a screening program for CDH was observed from this 11 year study, fully justifying a sustained program apart from the human misery an overlooked diagnosis may cause.
