GP7 Impact of a systematic risk based ultrasound screening program on open surgery rate in newborns with developmental dysplasia of the hip. (June 2019)

• Record Type: Journal Article
• Authors: Merchant, Rajiv; Mulrain, Jill; Power, Fiachra; O'Beirne, Joseph
• Is Part Of: Archives of disease in childhood. Volume 104:Supplement 3(2019)
• Page Start: A32
• Page End: A32
• Publication Date: 2019-06
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2019-epa.74
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Introduction Early detection of DDH can reduce the surgical morbidity in children. A risk based ultrasound (US) screening criteria was introduced which was audited to assess its impact on open surgical rate. Methodology: All newborns born in the years 2014–2016 referred to the screening US service were included in the study. Screening criteria included breech presentation, Maternal/1 st degree relative History of DDH and Abnormal Clinical Exam. All newborns were investigated and treated with a standardized algorithm. A Comparison group of newborns referred in 2011–2013 was used. Referrals for surgical opinion were done based on abnormal clinical or radiographic findings. Results: 494 newborns 6 weeks or younger were referred in screening group. 268 Patients were treated in harness. 42 were referred for surgical opinion. 17 required surgical treatment. 12 required EUA and arthrogram, 8 closed reduction, 11 pelvic osteotomy, 1 femoral osteotomy and 7 are currently being observed. In comparison prior to screening between 2011–2013 only 81 newborns 6 weeks or younger were referred of which 27 patients required open surgery. Conclusion: There was a significant increase in outpatient but not surgical burden due to introduction of screening criteria. There was a marked improvement in early referrals.