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Developmental dysplasia of the hip: real world data from a retrospective analysis to evaluate the effectiveness of
Danilo Buonsenso1,2, Antonietta Curatola3, Ilaria Lazzareschi1,2
1Department of Woman and Child Health and Public Health, Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, RM, Italy.
Insights
Universal ultrasound screening effectively detects developmental dysplasia of the hip (DDH) in infants, even those without risk factors or clinical signs. Enhanced training for pediatricians and neonatologists is recommended to improve early diagnosis and management of DDH.
Area of Science:
- Pediatrics
- Orthopedics
- Radiology
Background:
- Developmental dysplasia of the hip (DDH) is a significant cause of childhood disability with considerable socio-economic impact.
- Early detection and management of DDH are crucial to prevent long-term morbidity.
Purpose of the Study:
- To evaluate the effectiveness of a universal ultrasound screening protocol for DDH.
- To assess the knowledge of pediatricians and neonatologists regarding DDH.
Main Methods:
- Retrospective analysis of 4000 infant hip ultrasounds (Graf method) from January 2016 to April 2019.
- Assessment of risk factors: female gender, breech presentation, family history, twin birth.
- Anonymous questionnaire distributed to pediatricians and neonatologists to evaluate their knowledge.
Main Results:
- 1.2% of hips showed pathological ultrasound findings.
- Significant association found between female sex, breech presentation, and family history with pathological ultrasound results.
- Survey revealed inadequate medical school training on DDH, indicating a knowledge gap among healthcare professionals.
Conclusions:
- Universal ultrasound screening successfully identified DDH in children with normal clinical exams and no risk factors.
- The study highlights the need for targeted training programs for pediatricians and neonatologists on DDH detection and management.
Aims:
Developmental dysplasia of the hip is an important cause of disability in children and young adult and it also has a significant socio-economic impact in our society. The main objective of our study is to evaluate, in our hospital, the effectiveness of a universal ultrasound screening protocol and to assess the general knowledge about the theme of pediatricians and neonatologists.
Methods:
Retrospective study of infants born from January 2016 to April 2019, evaluated with hip ultrasound (Graf method). Risk factors assessed were female gender, breech presentation at birth, positive family history and twin birth. For the secondary objective, an anonymous and validated questionnaire was distributed to all pediatricians and neonatologists.
Results:
Among the 4000 hips analyzed, on ultrasound examination, 98.8% hips resulted mature or immature but appropriate for age, while 1,2% hips were pathological. Analyzing the mature or immature hips, 2,4% were positive on clinical examination and 97,6% were negative. In relation to ultrasound pathological hips, 33,3% have positive clinical examination, while 66,7% negative. From the analysis of risk factors a significant association emerged between female sex, breech presentation and family history with the ultrasound pathological findings. The results of Survey showed that inadequate training about developmental dysplasia of the hip is done during medical school.
Conclusions:
A universal ultrasound screening allowed us to identify developmental dysplasia of the hip in a number of children with normal clinical examination and no risk factors. Specific training courses should be implemented regarding Developmental Dysplasia of the Hip for neonatologists and pediatricians.
