Tong Sara H Y, Eid Mohamed A M, Chow Wang, To Michael K T
Division of Paediatric Orthopaedics, Department of Orthopaedics and Traumatology, The Duchess of Kent Children's Hospital at Sandy Bay, The University of Hong Kong.
J Orthop Surg (Hong Kong). 2011 Aug;19(2):200-3. doi: 10.1177/230949901101900214.
To review records of children referred to our hospital for developmental dysplasia of the hip (DDH) and evaluate the effectiveness of hip screening in Hong Kong.
Records of children suspected of DDH and referred to our hospital between 1 January 2005 and 31 March 2010 were reviewed. The diagnosis was based on static and dynamic ultrasonography of the hips and/or radiographic features of hip subluxation, dislocation, and pelvic dysplasia. The age of the children at presentation was recorded. Late diagnoses were those presenting after the age of 6 months. Late presentations were those presenting after the walking age.
Of 213 referred children, 33 were diagnosed to have DDH. Their mean age at presentation was 90.8 (range, 9-559) days. The female-to-male ratio was 2.9:1, and the mean follow-up duration was 25.1 (range, 4.2-50.3) months. 30 of the DDH infants were diagnosed before the age of 6 months, one at 8 months, and 2 were late presenters. Hence, the failure rate of the hip screening was 0.09 per 1000 live births. The remaining 180 were confirmed to be normal and followed up until the walking age. The point prevalence of DDH on Hong Kong Island was 0.87/1000 live births.
In light of the low point prevalence of DDH in Hong Kong born children, the protocol of universal clinical assessment and selective ultrasonographic screening of suspected cases is justified.
回顾转诊至我院的发育性髋关节发育不良（DDH）患儿的病历，评估香港地区髋关节筛查的效果。
回顾2005年1月1日至2010年3月31日期间转诊至我院疑似DDH患儿的病历。诊断基于髋关节的静态和动态超声检查及/或髋关节半脱位、脱位和骨盆发育异常的影像学特征。记录患儿就诊时的年龄。晚期诊断是指6个月龄后就诊的患儿。延迟就诊是指在会走路年龄后就诊的患儿。
在213例转诊患儿中，33例被诊断为DDH。他们就诊时的平均年龄为90.8（范围9 - 559）天。男女比例为2.9:1，平均随访时间为25.1（范围4.2 - 50.3）个月。30例DDH婴儿在6个月龄前被诊断，1例在8个月龄时被诊断，2例为延迟就诊。因此，髋关节筛查的失败率为每1000例活产0.09。其余180例被确认为正常并随访至会走路年龄。香港岛DDH的点患病率为每1000例活产0.87。
鉴于香港出生儿童中DDH的点患病率较低，普遍临床评估和对疑似病例进行选择性超声筛查的方案是合理的。
