Kamath Sri, Mehdi Ali, Wilson Neil, Duncan Rodrick
Whiston Hospital, Great Sankey, Warrington, UK.
J Pediatr Orthop B. 2007 May;16(3):189-91. doi: 10.1097/01.bpb.0000236229.44819.43.
The aim of our study was to establish whether the use of ultrasound to screen babies with risk factors has reduced the number of children presenting late with developmental dysplasia of the hip. Screening based on selection by risk factors was introduced in 1997. The average annual incidence from 1992 to 1996 was 0.84 and from 1997 to 2001 was 0.57 per 1000 live births. This decline in incidence of late developmental dysplasia of the hip was not significant (P=0.088). Sixty-four children (82%) had nothing that could be perceived as a risk factor for the condition. Our study presents population-based findings and it is clear that selective screening is not working in our region. It is unlikely that there will be one solution that could be applied throughout the United Kingdom given the diversity in the access to healthcare facilities. Clear leadership and accountability are required if we are to make any progress towards abolishing this condition that causes a significant morbidity in young adults.
我们研究的目的是确定使用超声对有风险因素的婴儿进行筛查是否减少了髋关节发育不良患儿的晚就诊数量。基于风险因素选择的筛查于1997年开始实施。1992年至1996年的年平均发病率为每1000例活产0.84例,1997年至2001年为0.57例。髋关节晚发性发育不良发病率的这种下降并不显著(P=0.088)。64名儿童(82%)没有任何可被视为该病风险因素的情况。我们的研究呈现了基于人群的研究结果,很明显,选择性筛查在我们地区不起作用。鉴于获得医疗保健设施的多样性,不太可能有一个适用于整个英国的解决方案。如果我们要在消除这种在年轻人中导致严重发病率的疾病方面取得任何进展,就需要明确的领导和问责制。