Who performs neonatal hip assessment: is there a cause for concern?

Area of Science:

• Pediatrics
• Orthopedics
• Public Health

Background:

• Developmental dysplasia of the hip (DDH) screening in the UK lags behind other European nations, with varied early detection strategies.
• Clinical detection of DDH is challenging and highly dependent on the examiner's experience.
• No prior studies have quantified the number of healthcare professionals involved in neonatal hip assessments.

Purpose of the Study:

• To review the current neonatal hip screening procedure in a UK teaching hospital.
• To assess the number of health professionals involved in neonatal hip assessments.
• To determine the number of hip examinations performed by each individual professional during the study period.

Main Methods:

• A retrospective observational study of 1037 consecutively born babies over a 14-week period in 2020.
• Data on initial baby checks were retrieved from the BadgerNet system.
• Follow-up data regarding ultrasound referrals or orthopedic outpatient appointments were collected from clinical records.

Main Results:

• 1037 babies were examined by 65 individual examiners across 9 different healthcare professional groups.
• The median number of examinations per examiner was 5.5, with 49% performing 5 or fewer assessments.
• Only one case of DDH requiring treatment was identified during neonatal assessment.

Conclusions:

• A high number of examiners involved in neonatal hip assessment leads to limited experience for most.
• The observed high rates of late DDH presentation align with national data.
• Further investigation into the potential association between examiner experience and late DDH presentation is warranted.