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Evaluating the effectiveness of the national hip dysplasia early diagnosis and treatment program

Emre Ergen, Ersen Turkmen, Mehmet Fethi Ceylan, Mehmet Aslan, Selma Felek.




Abstract

A significant decrease in late diagnosis and requirement for surgical treatment have been observed due to the implementation of the National Developmental Hip Dysplasia (DDH) Early Diagnosis and Treatment Program, which has been in existence for about 10 years. However, patients with delayed diagnosis are still admitted to our clinic for treatment. In this study, we aimed to evaluate the effectiveness of this program and reveal its deficiencies. Patients and methods: Sixty-one patients diagnosed or treated for ddh later than six months of life were included in the study. Patients born between 2011 and 2014 (Group 1) and between 2015 and 2018, during which time the early screening program was performed intensively (Group 2), were compared. The patients’ risk factors, whether a hip ultrasound (US) was performed, and the reasons for the delay in diagnosis and treatment were questioned retrospectively. The number of DDH patients in Group 2 decreased by approximately 3 times (45/16) (p = 0.0009). Although 37 (61%) patients had a hip US assessment within the first 6 months, their treatment was delayed, and normal USs were reported for 20 (33%) of them. Hip US was not performed in 24 (39%) patients within the first 6 months. The number of late-diagnosed and -treated babies with DDH decreased significantly in recent years, but this is not sufficient. Preventing late diagnoses should be the main goal. This study detected families’ negligence and lack of information, family physicians’ non-compliance with the program, and improper US assessment as the confounding reasons.

Key words: Hip dysplasia, early diagnosis, hip ultrasound, screening program






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