Wright Suzanne, Cotterell Elizabeth, Schmidt David
Physiotherapy Department, Armidale and New England Hospital, Armidale, New South Wales, Australia.
Tablelands Clinical School - Rural Medicine, University of New England, Armidale, New South Wales, Australia.
Aust J Rural Health. 2018 Jun;26(3):199-205. doi: 10.1111/ajr.12400. Epub 2017 Nov 23.
To describe hip dysplasia screening practices in a local rural health district.
Cross-sectional study of hospital birth records, local physiotherapy records, public community health electronic medical record (Community Health Information Management Enterprise database) and a survey of local clinicians who work with infants and children.
Three rural public hospitals and community health centres in a New South Wales health district.
Birth records (n = 196) from March 2012 to May 2012; attendance at child and family nurse checks (n = 788) May 2013-April 2014; 13 cases of managed developmental dysplasia of the hip (DDH) 2012 and local clinicians (n = 49).
At birth, the majority of infants (91%, 179/196) had documented hip screening. Community health records show this dropped to 75% (587/788) at 1-4 weeks and 29% (227/788) at 6-8 weeks. A survey of local clinicians (54% response rate; 49/91) revealed most (78%) screen for DDH and less than half (43%) use guidelines. Almost all (97%) clinicians reported screening for DDH at 6-8 weeks of age. Only 51% of clinicians reported having specific training for DDH screening and 76% would like further training. The rate of late DDH requiring management in 2012 was 0.87% (7/806) and the rate of late DDH requiring surgery was 0.25% (2/806).
DDH screening practices are well established at birth in the rural health district. There is variability in DDH screening practices beyond 8 weeks of age. Clinicians report variations in their knowledge and training. Training in DDH screening and hip screening prompts added to the personal health record might improve rates of DDH screening beyond 8 weeks of age.
描述当地农村卫生区的髋关节发育不良筛查情况。
对医院出生记录、当地物理治疗记录、公共社区卫生电子病历（社区卫生信息管理企业数据库）以及对从事婴幼儿工作的当地临床医生进行的一项横断面研究。
新南威尔士州一个卫生区的三家农村公立医院和社区卫生中心。
2012年3月至2012年5月的出生记录（n = 196）；2013年5月至2014年4月儿童及家庭护士检查的就诊情况（n = 788）；2012年13例接受治疗的髋关节发育不良（DDH）病例以及当地临床医生（n = 49）。
出生时，大多数婴儿（91%，179/196）有髋关节筛查记录。社区卫生记录显示，在1 - 4周时这一比例降至75%（587/788），在6 - 8周时降至29%（227/788）。对当地临床医生的一项调查（回复率54%；49/91）显示，大多数（78%）对DDH进行筛查，不到一半（43%）使用指南。几乎所有（97%）临床医生报告在6 - 8周龄时对DDH进行筛查。只有51%的临床医生报告接受过DDH筛查的专项培训，76%的医生希望接受进一步培训。2012年需要治疗的晚期DDH发生率为0.87%（7/806），需要手术的晚期DDH发生率为0.25%（（2/806）。
在农村卫生区，出生时的DDH筛查工作开展良好。8周龄后DDH筛查情况存在差异。临床医生报告其知识和培训存在差异。DDH筛查培训以及在个人健康记录中添加髋关节筛查提示可能会提高8周龄后DDH的筛查率。
