Screening programmes for developmental dysplasia of the hip in newborn infants

BACKGROUND Uncorrected developmental dysplasia of the hip (DDH) is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenita...

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Main Authors: Damon Shorter, Timothy Hong, David A. Osborn
Format: Article
Language:English
Published: Associação Paulista de Medicina
Series:São Paulo Medical Journal
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000200139&lng=en&tlng=en
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author Damon Shorter
Timothy Hong
David A. Osborn
author_facet Damon Shorter
Timothy Hong
David A. Osborn
author_sort Damon Shorter
collection DOAJ
description BACKGROUND Uncorrected developmental dysplasia of the hip (DDH) is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenital hip dislocation. METHODS Search methods: Searches were performed in CENTRAL (The Cochrane Library), MEDLINE and EMBASE (January 2011) supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants. Selection criteria: Randomized, quasi-randomized or cluster trials comparing the effectiveness of screening programmes for DDH. Data collection and analysis: Three independent review authors assessed study eligibility and quality, and extracted data. MAIN RESULTS No study examined the effect of screening (clinical and/or ultrasound) and early treatment versus not screening and later treatment. AUTHORS' CONCLUSIONS There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery.
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spelling doaj.art-53ece83683974c30971fa2b66001ac5b2022-12-22T02:25:59ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460131213914010.1590/S1516-31802013000100028S1516-31802013000200139Screening programmes for developmental dysplasia of the hip in newborn infantsDamon ShorterTimothy HongDavid A. OsbornBACKGROUND Uncorrected developmental dysplasia of the hip (DDH) is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenital hip dislocation. METHODS Search methods: Searches were performed in CENTRAL (The Cochrane Library), MEDLINE and EMBASE (January 2011) supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants. Selection criteria: Randomized, quasi-randomized or cluster trials comparing the effectiveness of screening programmes for DDH. Data collection and analysis: Three independent review authors assessed study eligibility and quality, and extracted data. MAIN RESULTS No study examined the effect of screening (clinical and/or ultrasound) and early treatment versus not screening and later treatment. AUTHORS' CONCLUSIONS There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000200139&lng=en&tlng=en
spellingShingle Damon Shorter
Timothy Hong
David A. Osborn
Screening programmes for developmental dysplasia of the hip in newborn infants
São Paulo Medical Journal
title Screening programmes for developmental dysplasia of the hip in newborn infants
title_full Screening programmes for developmental dysplasia of the hip in newborn infants
title_fullStr Screening programmes for developmental dysplasia of the hip in newborn infants
title_full_unstemmed Screening programmes for developmental dysplasia of the hip in newborn infants
title_short Screening programmes for developmental dysplasia of the hip in newborn infants
title_sort screening programmes for developmental dysplasia of the hip in newborn infants
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802013000200139&lng=en&tlng=en
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