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Twenty years experience of selective secondary ultrasound screening for congenital dislocation of the hip

Twenty years experience of selective secondary ultrasound screening for congenital dislocation of the hip
Twenty years experience of selective secondary ultrasound screening for congenital dislocation of the hip
Objectives: the authors report the results of a selective ultrasound screening programme for congenital dislocation of the hip (CDH) over a period of 20 years, with the aim of defining the rate of screening, conservative treatment and late presentation requiring surgery.
Methods: all neonates born from June 1988 to December 2008 (inclusive) were included in the prospective cohort, with a minimum follow-up of 12 months. All underwent an early clinical examination of the hips and those with clinical instability were referred for ultrasound at 2 weeks; those with risk factors were sonographically examined at 6 weeks. Risk factors were defined as breech presentation, family history or foot deformity.
Results: 107 440 live births were clinically examined, 20 344 (18.9%) were referred for ultrasound assessment at either 2 weeks (due to clinical signs) or 6 weeks (due to risk factors). 774 (3.8%) were diagnosed with dysplasia with a crude overall treatment rate of 7.2 per 1000 live births. 37 (0.34 per 1000) presented late, that is, after 12 weeks of age; none had detectable clinical signs or risk factors. There were no false negatives.
Conclusion: elective screening for developmental dysplasia of the hip in association with one stop treatment and monitoring is an effective programme. The number of infants referred increased statistically significantly year on year over the study period and generated more activity. Pavlik harness treatment rates remained acceptable and steady over the period, despite the increase in referrals. The incidence of late presenting cases ranged from 0 to 4 per year, with no secular trend and there were no ultrasound false negatives.
0003-9888
423-429
Clarke, Nicholas M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Reading, Isabel C.
6f832276-87b7-4a76-a9ed-b4b3df0a3f66
Corbin, Charles
7ee50208-f087-49d2-8b2e-45649cced684
Taylor, Colm C.
773e979d-aca8-43e9-82c8-c79931730ab7
Bochmann, Thomas
3918a173-eed4-42fd-b9de-e601710c6947
Clarke, Nicholas M.P.
76688c21-d51e-48fa-a84d-deec66baf8ac
Reading, Isabel C.
6f832276-87b7-4a76-a9ed-b4b3df0a3f66
Corbin, Charles
7ee50208-f087-49d2-8b2e-45649cced684
Taylor, Colm C.
773e979d-aca8-43e9-82c8-c79931730ab7
Bochmann, Thomas
3918a173-eed4-42fd-b9de-e601710c6947

Clarke, Nicholas M.P., Reading, Isabel C., Corbin, Charles, Taylor, Colm C. and Bochmann, Thomas (2012) Twenty years experience of selective secondary ultrasound screening for congenital dislocation of the hip. Archives of Disease in Childhood, 97 (5), 423-429. (doi:10.1136/archdischild-2011-301085). (PMID:22412044)

Record type: Article

Abstract

Objectives: the authors report the results of a selective ultrasound screening programme for congenital dislocation of the hip (CDH) over a period of 20 years, with the aim of defining the rate of screening, conservative treatment and late presentation requiring surgery.
Methods: all neonates born from June 1988 to December 2008 (inclusive) were included in the prospective cohort, with a minimum follow-up of 12 months. All underwent an early clinical examination of the hips and those with clinical instability were referred for ultrasound at 2 weeks; those with risk factors were sonographically examined at 6 weeks. Risk factors were defined as breech presentation, family history or foot deformity.
Results: 107 440 live births were clinically examined, 20 344 (18.9%) were referred for ultrasound assessment at either 2 weeks (due to clinical signs) or 6 weeks (due to risk factors). 774 (3.8%) were diagnosed with dysplasia with a crude overall treatment rate of 7.2 per 1000 live births. 37 (0.34 per 1000) presented late, that is, after 12 weeks of age; none had detectable clinical signs or risk factors. There were no false negatives.
Conclusion: elective screening for developmental dysplasia of the hip in association with one stop treatment and monitoring is an effective programme. The number of infants referred increased statistically significantly year on year over the study period and generated more activity. Pavlik harness treatment rates remained acceptable and steady over the period, despite the increase in referrals. The incidence of late presenting cases ranged from 0 to 4 per year, with no secular trend and there were no ultrasound false negatives.

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More information

e-pub ahead of print date: 12 March 2012
Published date: May 2012
Organisations: Primary Care & Population Sciences, Human Development & Health

Identifiers

Local EPrints ID: 337547
URI: https://eprints.soton.ac.uk/id/eprint/337547
ISSN: 0003-9888
PURE UUID: f3a1be5c-84c2-43aa-b708-462a2188c58c
ORCID for Isabel C. Reading: ORCID iD orcid.org/0000-0002-1457-6532

Catalogue record

Date deposited: 27 Apr 2012 10:47
Last modified: 10 May 2019 00:36

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