Exploring the screening and incidence of infants with developmental dysplasia of the hip (DDH)

Background DDH is one of the most common congenital defects in newborns. The overall incidence of DDH in the Republic of Ireland is unknown and there are only a small number of papers from an Irish setting reported. In... [ view full abstract ]

Background
DDH is one of the most common congenital defects in newborns. The overall incidence of DDH in the Republic of Ireland is unknown and there are only a small number of papers from an Irish setting reported. In addition, there are no definitive national guidelines in relation to the screening and treatment of DDH in Ireland. However, a hospital in the South of Ireland currently runs one of the few dedicated DDH clinics in the Republic of Ireland.
Aim and objectives
• To identify the true incidence and late diagnosis rates of DDH in the South of Ireland.
• To assess the effectiveness of treatment and screening methods in the region.
Method
• Phase 1 included a retrospective review of DDH referrals of infants born in 2012 and 2013 who attended the DDH clinic. It provided valuable data regarding incidence rates, late diagnosis rates, treatment rates and ultrasound reliability rates in DDH detection.
• SPSS 21.0 software package was used for data entry and statistical analysis.
• Ethical approval was granted from the local Regional Ethics Committee (19th May 2014).
Findings
The total number that attended the clinic was 195 children (female 70%; male 30%). Of these 35.6% were referred to the clinic before 12 weeks of age and 64% were referred after 12 weeks of age. The remaining 4% were referred after 52 weeks of age. A diagnostic ultrasound was completed for 44% of children and an x-ray for all children. The main risk factor for referral included family history (48%) followed by breech delivery (15%). Treatment included use of the Pavlic Harness (30%); Boston Brace (47%); tertiary referral for surgery (9%) and observation (14%).
Conclusion and implications
This study will:
• Provide valuable data regarding incidence rates of DDH, late diagnosis rates, successful treatment rates and ultrasound reliability rates in DDH detection in the South Eastern region of Ireland.
• Provide a basis for an evaluation of current treatment and services provision in Ireland.
• Provide valuable data to draw wider inferences for the development of care packages for health professionals and parents.