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Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy

Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy
Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy
Background: Clinicians use various criteria to diagnose developmental dysplasia of the hip (DDH) in early infancy, but the importance of these various criteria for a definite diagnosis is controversial. The lack of uniform, widely agreed-on diagnostic criteria for DDH in patients in this age group may result in a delay in diagnosis of some patients.

Questions/Purposes: Our purpose was to establish a consensus among pediatric orthopaedic surgeons worldwide regarding the most relevant criteria for diagnosis of DDH in infants younger than 9 weeks.

Material and Methods: We identified 212 potential criteria relevant for diagnosing DDH in infants by surveying 467 professionals. We used the Delphi technique to reach a consensus regarding the most important criteria. We then sent the survey to 261 orthopaedic surgeons from 34 countries.

Results: The response rate was 75%. Thirty-seven items were identified by surgeons as most relevant to diagnose DDH in patients in this age group. Of these, 10 of 37 (27%) related to patient characteristics and history, 13 of 37 (35%) to clinical examination, 11 of 37 (30%) to ultrasound, and three of 37 (8%) to radiography. A Cronbach alpha of 0.9 for both iterations suggested consensus among the panelists.

Conclusion: We established a consensus regarding the most relevant criteria for the diagnosis of DDH in early infancy and established their relative importance on an international basis. The highest ranked clinical criteria included the Ortolani/Barlow test, asymmetry in abduction of 20° or greater, breech presentation, leg-length discrepancy, and first-degree relative treated for DDH.

Level of Evidence: Level IV, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
0009-921X
3451-3461
Roposch, Andreas
f7449b37-9452-47e9-b695-c423b01d764b
Liu, Liang Q.
f8159000-400f-4bc7-904f-f8ee3d52af0f
Hefti, Fritz
10188cd2-899f-4bf6-a623-89ad928dec9e
Clarke, Nicholas M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Wedge, John H.
dbe8b640-2c1f-459b-80a3-4c32033291e7
Roposch, Andreas
f7449b37-9452-47e9-b695-c423b01d764b
Liu, Liang Q.
f8159000-400f-4bc7-904f-f8ee3d52af0f
Hefti, Fritz
10188cd2-899f-4bf6-a623-89ad928dec9e
Clarke, Nicholas M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Wedge, John H.
dbe8b640-2c1f-459b-80a3-4c32033291e7

Roposch, Andreas, Liu, Liang Q., Hefti, Fritz, Clarke, Nicholas M.P. and Wedge, John H. (2011) Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy. Clinical Orthopaedics and Related Research, 469 (12), 3451-3461. (doi:10.1007/s11999-011-2066-9). (PMID:21952742)

Record type: Article

Abstract

Background: Clinicians use various criteria to diagnose developmental dysplasia of the hip (DDH) in early infancy, but the importance of these various criteria for a definite diagnosis is controversial. The lack of uniform, widely agreed-on diagnostic criteria for DDH in patients in this age group may result in a delay in diagnosis of some patients.

Questions/Purposes: Our purpose was to establish a consensus among pediatric orthopaedic surgeons worldwide regarding the most relevant criteria for diagnosis of DDH in infants younger than 9 weeks.

Material and Methods: We identified 212 potential criteria relevant for diagnosing DDH in infants by surveying 467 professionals. We used the Delphi technique to reach a consensus regarding the most important criteria. We then sent the survey to 261 orthopaedic surgeons from 34 countries.

Results: The response rate was 75%. Thirty-seven items were identified by surgeons as most relevant to diagnose DDH in patients in this age group. Of these, 10 of 37 (27%) related to patient characteristics and history, 13 of 37 (35%) to clinical examination, 11 of 37 (30%) to ultrasound, and three of 37 (8%) to radiography. A Cronbach alpha of 0.9 for both iterations suggested consensus among the panelists.

Conclusion: We established a consensus regarding the most relevant criteria for the diagnosis of DDH in early infancy and established their relative importance on an international basis. The highest ranked clinical criteria included the Ortolani/Barlow test, asymmetry in abduction of 20° or greater, breech presentation, leg-length discrepancy, and first-degree relative treated for DDH.

Level of Evidence: Level IV, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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More information

Published date: December 2011
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 337544
URI: http://eprints.soton.ac.uk/id/eprint/337544
ISSN: 0009-921X
PURE UUID: 6fa05c46-1e2f-4c43-b31a-a40046c1382b

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Date deposited: 27 Apr 2012 10:18
Last modified: 14 Mar 2024 10:54

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Contributors

Author: Andreas Roposch
Author: Liang Q. Liu
Author: Fritz Hefti
Author: John H. Wedge

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