Abstract
To determine whether reducing the splintage rate in DDH patients had any effect on the rate of surgical procedures for the treatment of DDH. .
Since 1991, in the Blackburn region, there has been a limited target ultrasound screening programme for developmental dysplasia of the hip.
The detailed records of the demographics, clinical and ultrasound findings, treatment and outcomes of all children screened by the senior author were reviewed.
In 1996 and 1997 only those with persistent major dysplasia at 8 weeks and those with dislocatable hips were placed into Pavlik harnesses.
In 1998 only those babies with persistent major dysplasia at 8 weeks of age, or persistent hip instability at 1–2 weeks were placed into Pavlik harnesses.
The splintage rates, late dislocation rates (diagnosed after 6 mnths of age) and surgery rates were determined.
During the study period 11164 babies were born in the region. 797 (7.1%) babies were seen by the senior author.
Surgery in early irreducible hips is unavoidable. Surgery in late dislocators is only avoidable by changing from a selective ultrasound screening policy to performing ultrasound screening on every baby born.
With a limited hip screening programme and clinical and ultrasound monitoring of patients, splintage rates can be minimised without increasing the rate of surgery for developmental dysplasia.
No child who would have been splinted by the criteria used by other centres, and who wasn’t splinted in this series, required surgery.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
