Developmental dysplasia of the hip: why are we still operating on them? A plea for institutional newborn clinical screening

Singapore Medical Journal
Wu Chean LeeArjandas Mahadev

Abstract

Developmental dysplasia of the hip (DDH) is a common orthopaedic condition at birth. Non-surgical management with the Pavlik harness can effectively treat DDH in the newborn by providing an early clinical diagnosis, but open surgeries continue to be performed. We aimed to elucidate the reasons for this. A retrospective review was performed of all open surgeries related to DDH from 2006 to 2016. Patients were either born at our institution (Group 1) or outside of it (Group 2). All Group 1 newborns were routinely screened for DDH at birth. 27 patients (Group 1: n = 5, Group 2: n = 22) presented at age 25 ± 19 months. Left-sided DDH (n = 21, 77.8%) and female infants (n = 22, 81.5%) were more common. The mean age at surgery was 40 ± 31 months. The most commonly performed procedure was soft tissue release open reduction with acetabuloplasty (n = 20, 74.1%). Gender, site, median age at presentation and at surgery, and prevalence of risk factors were similar for both groups. Both groups were mostly made up of late presenters (> 3 months; p = 0.34). A few patients had undergone prior treatment (p = 0.64). Newborn screening was the only significantly different variable between the groups (p < 0.01). Lack of institutionalised newborn cl...Continue Reading

References

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Jul 16, 2008·Acta Orthopaedica·Per Haavwardsholm FinneThor Willy Ruud Hansen
May 15, 2012·Orthopaedics & Traumatology, Surgery & Research : OTSR·C MorinUNKNOWN French Society of Pediatric Orthopaedics
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Jun 2, 2016·Indian Journal of Pediatrics·James TomlinsonJames Alfred Fernandes

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Citations

Jun 28, 2019·Singapore Medical Journal·Wu Chean LeeArjandas Mahadev

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