Department of Orthopaedic Surgery, University Hospital Waterford, Waterford, X91 ER8E, Ireland.
Department of Radiology, University Hospital Waterford, Waterford, X91 ER8E, Ireland.
Ir J Med Sci. 2021 Feb;190(1):233-238. doi: 10.1007/s11845-020-02296-2. Epub 2020 Jul 9.
Screening for developmental hip dysplasia (DDH) continues to evolve with the use of ultrasound (US) in either selective or universal screening methods. The possibility of delayed evidence of DDH, and thus the need for radiographic follow-up at a later stage of development have been suggested by some authors.
The aim of this review was to evaluate the number of patients in our hospital network with a normal screening US at 6 weeks with evidence of DDH at the time of radiographic review at 6 months. Secondary aim; to determine the outcomes for these patients.
A retrospective review was done to infants undergoing DDH ultrasound screening between January and December 2015. Initial US and radiographs at 6 months were reviewed. Patients with normal screening US who had subsequent radiographs were included for analysis.
In total, there were 829 patients included for analysis. Sixty-three patients (8%) had evidence of DDH at 6 months, representing 34% of all DDH diagnoses for the study period. Five of the 63 patients were lost to follow-up. The remaining 58 babies were treated in Boston bracing. Four patients with evidence of persistent DDH were referred for tertiary review. The osteotomy rate in the radiograph diagnosed group was 2%, versus 6% and 3% in the unstable and US diagnosed groups, respectively.
Eight percent of patients with a normal screening US had evidence of DDH at time of radiograph at 6 months, reflecting 34% of all our DDH cases for the year. Based on these findings, patients in our hospital network undergo radiographic evaluation at 6 months even if the initial screening US is normal.
随着超声（US）在选择性或普遍性筛查方法中的应用，发育性髋关节发育不良（DDH）的筛查不断发展。一些作者提出，DDH 的证据可能会延迟出现，因此需要在发育的后期阶段进行放射学随访。
本研究旨在评估我们医院网络中在 6 周时接受正常筛查 US 的患者中，在 6 个月时进行放射学复查时发现 DDH 的患者数量。次要目的；确定这些患者的结局。
对 2015 年 1 月至 12 月期间接受 DDH 超声筛查的婴儿进行回顾性研究。回顾初始 US 和 6 个月时的 X 光片。对接受正常筛查 US 但随后接受 X 光片检查的患者进行分析。
共有 829 名患者纳入分析。63 名患者（8%）在 6 个月时出现 DDH 证据，占研究期间所有 DDH 诊断的 34%。这 63 名患者中有 5 名失访。其余 58 名婴儿接受了波士顿支具治疗。4 名有持续性 DDH 证据的患者被转介进行三级评估。放射诊断组的截骨率为 2%，不稳定组和 US 诊断组分别为 6%和 3%。
8%接受正常筛查 US 的患者在 6 个月时 X 光片检查有 DDH 证据，反映了我们当年所有 DDH 病例的 34%。基于这些发现，即使初始筛查 US 正常，我们医院网络中的患者也需要在 6 个月时进行放射学评估。
