Abstract
Aim: In Germany an ultrasound screening examination to determine CDH is recommended for all children in the first 6 weeks of life. We evaluated this ultrasound-screening-program together with the German Association of health insurance carriers over five years to show if an early ultrasound of the hip can reduce the number and the required operative procedures of children with CDH.
Methods: From 1997 to 2002, we documented monthly all children with CDH aged ten weeks up to five years from all German paediatric orthopaedic departments with a registration card and questionnaire. Children with neuromuscular diseases or teratologic dislocation of the hip, enrolled in out-patient treatment programs, as well as children born abroad were excluded.
Results: Overall we registered 645 children, 534 with single operative procedure. 68% received a closed reduction of the hip, 11% open, while 21% required an oste-otomy of the acetabulum and/or femur. The percentage of the single operative procedures did not change over the years. The number of children, who underwent no ultrasound of the hip before diagnosis decreased from 20% in the first year to 10% in the last. The first ultrasound examination revealed no pathological findings in 20% of the cases. During the five years children received the first screening more and more at the age four to six weeks than during the first days of life. Nevertheless, the yearly number of cases declined by 50%.
Conclusion: Despite the German ultrasound-screening-program late or undiagnosed CDH still exists in our country. A possible reason can be the quality of ultrasound examination, the form of treatment as well as a later worsening of CDH and the so-called endogenous dysplasia. The aim must be the improvement of diagnosis and treatment.
Local Host: British Society for Children’s Orthopaedic Surgery. Conference Theme: Congenital Deficiencies of the Lower Limb. These abstracts were prepared by A.Catterall.
