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Screening for developmental dysplasia of the hip in Hong Kong
Sara H Y Tong1, Mohamed A M Eid, Wang Chow
1Division of Paediatric Orthopaedics, Department of Orthopaedics and Traumatology, The Duchess of Kent Children's Hospital at Sandy Bay, The University of Hong Kong.
Insights
Hip screening for developmental dysplasia of the hip (DDH) in Hong Kong shows a low failure rate. This study confirms the effectiveness of current screening protocols for DDH in infants.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Public Health
Background:
- Developmental dysplasia of the hip (DDH) is a condition affecting infants.
- Early detection and treatment are crucial for optimal outcomes.
- Assessing screening effectiveness is vital for public health strategies.
Purpose of the Study:
- To evaluate the effectiveness of hip screening for developmental dysplasia of the hip (DDH) in Hong Kong.
- To analyze the diagnostic yield and failure rate of the current screening protocol.
Main Methods:
- Retrospective review of records for children referred for suspected DDH.
- Diagnosis confirmed via ultrasonography and/or radiographic features.
- Analysis of age at presentation, sex ratio, and follow-up duration.
Main Results:
- 33 out of 213 referred children were diagnosed with DDH.
- The point prevalence of DDH was 0.87 per 1000 live births.
- The hip screening failure rate was 0.09 per 1000 live births, with most cases diagnosed before 6 months.
Conclusions:
- The current protocol of universal clinical assessment and selective ultrasonographic screening is justified.
- Low point prevalence supports the continued use of this screening strategy.
- Effective screening contributes to timely diagnosis and management of DDH.
Purpose:
To review records of children referred to our hospital for developmental dysplasia of the hip (DDH) and evaluate the effectiveness of hip screening in Hong Kong.
Methods:
Records of children suspected of DDH and referred to our hospital between 1 January 2005 and 31 March 2010 were reviewed. The diagnosis was based on static and dynamic ultrasonography of the hips and/or radiographic features of hip subluxation, dislocation, and pelvic dysplasia. The age of the children at presentation was recorded. Late diagnoses were those presenting after the age of 6 months. Late presentations were those presenting after the walking age.
Results:
Of 213 referred children, 33 were diagnosed to have DDH. Their mean age at presentation was 90.8 (range, 9-559) days. The female-to-male ratio was 2.9:1, and the mean follow-up duration was 25.1 (range, 4.2-50.3) months. 30 of the DDH infants were diagnosed before the age of 6 months, one at 8 months, and 2 were late presenters. Hence, the failure rate of the hip screening was 0.09 per 1000 live births. The remaining 180 were confirmed to be normal and followed up until the walking age. The point prevalence of DDH on Hong Kong Island was 0.87/1000 live births.
Conclusion:
In light of the low point prevalence of DDH in Hong Kong born children, the protocol of universal clinical assessment and selective ultrasonographic screening of suspected cases is justified.
