Developmental dysplasia of the hip screening programme in Chile
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Matías F Sepúlveda1,2, Juan A Pérez1, Esteban A Saban1
1Universidad Austral de Chile, Valdivia, Chile.
Insights
Chile's national screening for developmental dysplasia of the hip (DDH) program effectively identified and treated children. The program demonstrated substantial public health benefits, with fewer major surgical procedures needed.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Public Health
Background:
- Developmental dysplasia of the hip (DDH) presents a spectrum of conditions, from mild acetabular dysplasia to complete congenital hip dislocation.
- Screening programs are crucial for early identification and treatment of DDH.
- Chile implemented a national DDH program in 2009.
Purpose of the Study:
- To evaluate the outcomes of Chile's national DDH screening program.
- To analyze data from patients born between 2010 and 2015.
Main Methods:
- Retrieved hospitalization records from national databases (2010-2019).
- Selected patients born between 2010-2015 requiring surgical treatment for DDH within their first five years.
- Analyzed sex, type of first surgical procedure, and age at first procedure.
Main Results:
- 961 children underwent procedures for DDH.
- Major procedures (269) were less common than minor procedures (692).
- Incidence of major procedures was 0.18 per 1000 live births; boys had higher rates of major procedures (39.2%) than girls (26.2%).
Conclusions:
- The Chilean National DDH Screening Program is effective.
- The program offers significant public health benefits.
- Early screening and intervention reduce the need for major surgical treatments.
Purpose:
Developmental dysplasia of the hip (DDH) encompasses a wide pathological spectrum, from mild acetabular dysplasia to complete congenital hip dislocation at birth. Screening policies have been implemented in an effort to effectively identify and treat patients with DDH. Since 2009 there has been a national DDH programme in Chile. The current study evaluates the results of the programme in patients born between 2010 and 2015.
Methods:
Records of patients hospitalized from 1st January 2010 to 31st December 2019 were retrieved from national databases. Those born from 1st January 2010 to 31st December 2015 who underwent a procedure for DDH under general anaesthesia during their first five years of life were selected. Sex, first surgical procedure and age at first surgical procedure were analyzed. The incidence of DDH that required major surgical treatment was calculated.
Results:
A total of 961 children born from 1st January 2010 to 31st December 2015 underwent a procedure for DDH during their first five years of life. The number of major procedures was significantly lower than the number of minor procedures (269 vs 692). The incidence of major procedures was 0.18 per 1000 live births. Girls underwent a higher number of procedures than boys (831 vs 130), whereas 39.2% of the boys and 26.2% of the girls had major procedures. The mean age at the time of the first procedure was 15.35 months (sd 10.09; range 0.03 to 55.92 months).
Conclusion:
The present study suggests that the Chilean National DDH Screening Program is an appropriate programme with substantial benefits with respect to public health.
Level Of Evidence:
II.
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