Selective Ultrasound Screening for DDH 1991-2006
- Conditions
- Developmental Dysplasia of the Hip
- Registration Number
- NCT01866527
- Lead Sponsor
- University of Bergen
- Brief Summary
Early treatment is considered essential for developmental dysplasia of the hip (DDH), but the choice of screening strategy is debated. The investigators evaluated the effect of a selective ultrasound (US) screening programme.
All infants born in a defined region during 1991-2006 with increased risk of DDH, i.e. clinical hip instability, breech presentation, congenital foot deformities or a family history of DDH, were subjected to US screening at age one to three days. Severe sonographic dysplasia and/or dislocatable/dislocated hips were treated with abduction splints. Mild dysplasia and/or pathological instability, i.e. not dislocatable/dislocated hips were followed clinically and sonographically until spontaneous resolution, or until treatment became necessary. The minimum observation period was 5,5 years.
- Detailed Description
Of 81564 newborns, 11539 (14,1%) were identified as at risk, of which 11190 (58% girls) were included for further analyses. Of the 81564 infants, 2433 (3•0%) received early treatment; 1882 (2,3%) from birth and 551 (0,7%) after six weeks or more of clinical and sonographic surveillance. Another 2700 (3,3%) normalised spontaneously after watchful waiting from birth. Twenty-six infants (0,32 per 1000, 92% girls, two from the risk group) presented with late subluxated/dislocated hips (after one month of age). Another 126 (1,5 per 1000, 83% girls, one from the risk group) were treated after isolated late residual dysplasia. Thirty-one children (0,38 per 1000) had surgical treatment before age five years. Avascular necrosis was diagnosed in seven of all children treated (0.27%), four after early and three after late treatment.
Interpretation The first 16 years of a standardised selective US screening programme for DDH resulted in acceptable rates of early treatment and US follow-ups, and low rates of late subluxated/dislocated hips compared to similar studies.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 81564
- born at Haukeland University hospital January 1991-December 2006
- Children with DDH due to neuromuscular syndromes were excluded.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method late dislocated or subluxated hips first 5 years of life late detected after 1 month of life, requiring treatment
- Secondary Outcome Measures
Name Time Method Number of participants who receive ultrasound follow-up for 6 weeks or more first months of life Number of participants who receive ultrasound follow-up (i.e sonographic surveillance) for 6 weeks or more
early treatment first months of life abduction treatment for DDH
first surgical treatment first five years of life the need for a first surgical treatment the first 5 years of life (closed and open reductions, osteotomies)
avascular necrosis of femoral head first five years of life avascular necrosis of femoral head as complication to treatment
Related Research Topics
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Trial Locations
- Locations (1)
Paediatric section, Radiology department, Haukeland University hospital, Bergen, Norway
🇳🇴Bergen, Norway
Paediatric section, Radiology department, Haukeland University hospital, Bergen, Norway🇳🇴Bergen, Norway