Developmental dysplasia of the hip: why are we still operating on them? A plea for institutional newborn clinical screening

Lee, Wu Chean; Gera, Sumanth Kumar; Mahadev, Arjandas

doi:10.11622/smedj.2018064

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…5 The reasons DDH management remains non-standardized are multifactorial, for reasons such as population size and definition of incidence rates differences as illustrated by our findings, distribution of healthcare resources and infrastructure, and differing opinions on clinical exam findings suggestive of DDH. 11,20,35 One country's journey toward developing a newborn screening program highlighted several difficulties in reviewing the available literature. Singapore is one of the countries that did not have a searchable screening program.…”

Section: Discussionmentioning

confidence: 99%

“…10,11,36 Reasons for difficulties encompassed the gap between neonatology clinical screening and orthopedic referral, concerns a typical hip at the time of neonatal screen later develops dysplasia, variations in patient population characteristics, and ongoing debates about the timing of a screening ultrasound. 10,11 The recent literature in Singapore provided an interesting look into the controversies present in a well-developed nation (ranked eighth in the global health index), which lacks a DDH screening program despite pediatric orthopedists and neonatologists' recommendations. 10,11,16,36 Our study has limitations and some study design flaws.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 The recent literature in Singapore provided an interesting look into the controversies present in a well-developed nation (ranked eighth in the global health index), which lacks a DDH screening program despite pediatric orthopedists and neonatologists' recommendations. 10,11,16,36 Our study has limitations and some study design flaws. Despite the rigorous and tiered search strategy, no screening program was identified in five countries, representing possible exclusion bias.…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Which practitioners should perform the screening? 11 , 12 Moreover, many other issues persist, such as standardization of training for ultrasound examination of infant hips.…”

Section: Purposementioning

confidence: 99%

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Globally inconsistent: Countries with top health indices erratic developmental hip dysplasia screening protocols

Zusman,

Castañeda,

Goldstein

2024

Journal of Children's Orthopaedics

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Purpose: Developmental hip dysplasia is a prevalent pediatric musculoskeletal condition that lacks international standardized screening. We sought to characterize developmental hip dysplasia screening practices in countries with the top global health indices. We also explored diverse definitions in reported epidemiologic rates of this condition. Methods: We performed a scoping review of developmental hip dysplasia screening protocols utilizing countries ranked in the top 25 of the Bloomberg Global Health Index using a protocolized search strategy, progressing from academic to layperson sources. A reference was eligible for inclusion if it mentioned the countries’ screening program and developmental hip dysplasia was the pathology of concern. Incidence rates, when present, were also recorded. The United States Census Bureau’s International Database tool provided countries’ populations. We compiled the data and performed descriptive statistics and appropriate validation methods. Results: Twenty countries (80%) had searchable screening programs. Clinical screening with selective universal screening was the most commonly observed (n = 16). Four countries had universal ultrasound screening: Switzerland, Austria, Germany, and Slovenia. Five countries did not have searchable programs. No countries employed radiographic screening. Incidence rates were expressly stated in the literature for nine countries; however, the cohort of interest varied from developmental hip dysplasia versus severity of developmental hip dysplasia versus miscellaneous (e.g. requiring hospitalization). Conclusion: The findings of this investigation highlight international inconsistencies regarding developmental hip dysplasia screening and epidemiologic data. Screening variations exist despite consensus statements calling for uniformity. We agree with prior literature advocating for increasing consistency in developmental hip dysplasia management or, at a minimum, increasing transparency regarding how we manage these young patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 Which practitioners should perform the screening? 11 , 12 Moreover, many other issues persist, such as standardization of training for ultrasound examination of infant hips.…”

Section: Purposementioning

confidence: 99%

See 2 more Smart Citations

Globally inconsistent: Countries with top health indices erratic developmental hip dysplasia screening protocols

Zusman,

Castañeda,

Goldstein

2024

Journal of Children's Orthopaedics

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“…A local study conducted in 2015 showed that institutionalised newborn clinical screening appears to be the single most important factor for the prevention of late presentation of DDH, which leads to open surgery. (46)…”

Section: Developmental Dysplasia Of the Hipsmentioning

confidence: 99%

Evolution and expansion of newborn screening programmes in Singapore

Rajadurai¹,

Yip²,

Lim³

et al. 2021

smedj

Self Cite

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In Singapore, the newborn screening programme was started in 1965 in order to reduce the high neonatal mortality and neurological morbidity owing to severe hyperbilirubinaemia caused by erythrocyte glucose-6-phosphate dehydrogenase deficiency. About 25 years later, the national newborn screening for congenital hypothyroidism was established. Subsequently, universal newborn hearing screening and screening for multiple inborn errors of metabolism using tandem mass spectrometry were introduced as national programmes in 2003 and 2006, respectively. All these programmes are widely accepted as standards of care, and practically every newborn is screened despite the absence of any legislation. Two other evidence-based bedside screening tests, namely pulse oximetry screening for critical congenital heart disorders and physical examination of the hips for developmental dysplasia of the hips with selected ultrasonographic screening have been widely performed in hospitals, and they are soon expected to be in the national screening programmes.

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Prognostic factors for failed Pavlik harness treatment in infants with developmental dysplasia of the hip: a retrospective cohort study

Abdulla

Ashoor

Heinz

et al. 2023

International Orthopaedics (SICOT)

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Developmental dysplasia of the hip: why are we still operating on them? A plea for institutional newborn clinical screening

Cited by 5 publications

References 12 publications

Globally inconsistent: Countries with top health indices erratic developmental hip dysplasia screening protocols

Globally inconsistent: Countries with top health indices erratic developmental hip dysplasia screening protocols

Evolution and expansion of newborn screening programmes in Singapore

Prognostic factors for failed Pavlik harness treatment in infants with developmental dysplasia of the hip: a retrospective cohort study

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