Abstract
The purpose of this study was to audit screening and treatment programmes for Developmental Dysplasia of the Hip (DDH) over a 12-year period from 1989 to 2000 with respect to late presentation and treatment rate and duration.
All babies born in Queen Mary Hospital are clinically screened for DDH by a consultant orthopaedic surgeon. Unstable hips are treated by Pavlik Harness and attend an ultrasound clinic run by an orthopaedic surgeon within 2 weeks. High-risk babies or those with suspected instability can also be referred for ultrasound. Serial ultrasound exams assisted with determining the duration of splintage. Radiographs are taken at 4 to 6 months. Late presenters were identified and analysed.
Over the 12-year period 13 cases of late presenting DDH were identified (0.6 per 1000). Half of these had not been screened. None had ultrasound screening. Our treatment rate was approximately 4 per 1000 live births.
Our screening programme can be improved by increased capture of patients for clinical screening. Ultrasound is a useful tool in managing neonatal hip instability allowing duration of splintage to be tailored to the individual and allows early detection of treatment failure.
Correspondence should be addressed to the editorial secretary: Associate Professor Jean-Claude Theis, Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
