O2424 CAN AN ULTRASOUND-SCREENING-PROGRAM OF THE HIP REDUCE THE NUMBER AND KIND OF OPERATIVE PROCEDURE DUE TO CDH IN CHILDREN?

Abstract

Aim: In Germany an ultrasound screening for CDH is recommended for all children in the þrst 6 weeks of life. We evaluated this program together with the German Association of health insurance carriers over þve 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 otherwise healthy children with CDH aged ten weeks up to þve years in all German orthopaedic paediatric departments with a registration card and questionnaire. 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 osteotomy 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 þrst year to 10% in the last. The þrst ultrasound examination revealed no pathological þndings in 20% of the cases. Children received the þrst screening more and more at the age four to six weeks than during the þrst days of life. Nevertheless, the yearly number of cases declined by 50%. Conclusion: Despite the 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.