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Selective screening for DDH in Wessex: the Southampton experience

Selective screening for DDH in Wessex: the Southampton experience
Selective screening for DDH in Wessex: the Southampton experience
Introduction: There is some debate about the pros and cons of selective screening of DDH in neonates as opposed to general screening. General screening puts a lot of stress on the resources available, especially in the modern day NHS, but the advocates state that this minimises the cost incurred in treating a missed DDH (by selective screening) with surgery later on.
Aim: The aim of this retrospective study was to find out the effectiveness of the Southampton selective screening of babies with risk factors for DDH by finding out the number of patients presenting late with an established DDH.
Materials And Methods: 6116 babies out of 26,932 live births (22.7%) in Southampton were screened between 1998 and 2003. The details of the individual outcomes and the reasons for the late presentation were obtained from the patient notes and the records of the screening program which are maintained in the clinics and by the senior author.
Results: 248 new patients had Pavlik’s harness fitted for the treatment of DDH which presents a treatment rate of 0.92%. 8 patients (0.03%) presented late because they did not undergo ultrasound scanning as they did not have the risk factors as required by this selective program. 10 (0.036%) failed Pavlik’s and needed late surgery to have their DDH treated. The total operation rate was 0.066%.
Discussion: The late presentation of patients in this screening program is very low and comparable to the other papers from this department and from around the world. The cost implications of treating these 8 late presenting patients was found to be a lot cheaper than carrying out a general screening program which would mean, in this case 4 times more than the cost of the present screening program.
0301-620X
p.435
Sakthivel, V.K.
3c9cef5b-85e5-4df8-ba8f-f1aab97b3c83
Goddard, M.
bd52d741-1b9a-4b68-969b-a0c84526063a
Sabouni, M.Y.
24e5bbfa-6de3-461d-9768-803d978f2bff
Clarke, N.M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Sakthivel, V.K.
3c9cef5b-85e5-4df8-ba8f-f1aab97b3c83
Goddard, M.
bd52d741-1b9a-4b68-969b-a0c84526063a
Sabouni, M.Y.
24e5bbfa-6de3-461d-9768-803d978f2bff
Clarke, N.M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac

Sakthivel, V.K., Goddard, M., Sabouni, M.Y. and Clarke, N.M.P. (2006) Selective screening for DDH in Wessex: the Southampton experience. Journal of Bone and Joint Surgery, 88-B (Supplement III), p.435.

Record type: Article

Abstract

Introduction: There is some debate about the pros and cons of selective screening of DDH in neonates as opposed to general screening. General screening puts a lot of stress on the resources available, especially in the modern day NHS, but the advocates state that this minimises the cost incurred in treating a missed DDH (by selective screening) with surgery later on.
Aim: The aim of this retrospective study was to find out the effectiveness of the Southampton selective screening of babies with risk factors for DDH by finding out the number of patients presenting late with an established DDH.
Materials And Methods: 6116 babies out of 26,932 live births (22.7%) in Southampton were screened between 1998 and 2003. The details of the individual outcomes and the reasons for the late presentation were obtained from the patient notes and the records of the screening program which are maintained in the clinics and by the senior author.
Results: 248 new patients had Pavlik’s harness fitted for the treatment of DDH which presents a treatment rate of 0.92%. 8 patients (0.03%) presented late because they did not undergo ultrasound scanning as they did not have the risk factors as required by this selective program. 10 (0.036%) failed Pavlik’s and needed late surgery to have their DDH treated. The total operation rate was 0.066%.
Discussion: The late presentation of patients in this screening program is very low and comparable to the other papers from this department and from around the world. The cost implications of treating these 8 late presenting patients was found to be a lot cheaper than carrying out a general screening program which would mean, in this case 4 times more than the cost of the present screening program.

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More information

Published date: 2006
Additional Information: British Society of Children's Orthopaedic Surgeons: Milton Keynes – 27 January, 2006
Organisations: Medicine

Identifiers

Local EPrints ID: 61488
URI: http://eprints.soton.ac.uk/id/eprint/61488
ISSN: 0301-620X
PURE UUID: 5ad01f63-6dfd-4f26-a888-9af1c4f2247f

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Date deposited: 07 Apr 2009
Last modified: 11 Dec 2021 18:05

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Contributors

Author: V.K. Sakthivel
Author: M. Goddard
Author: M.Y. Sabouni
Author: N.M.P. Clarke

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