Hooper Nikki, Aroojis Alaric, Narasimhan Ramani, Schaeffer Emily K, Habib Eva, Wu Judy K, Taylor Isabel K, Burlile Jessica F, Agrawal Aniruddh, Shea Kevin, Mulpuri Kishore
Department of Orthopaedic Surgery, Canterbury District Health Board, Christchurch, New Zealand.
Department of Pediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012 India.
Indian J Orthop. 2020 Aug 20;55(1):158-168. doi: 10.1007/s43465-020-00233-0. eCollection 2021 Feb.
We evaluated screening, referral and treatment practices for developmental dysplasia of the hip (DDH) in India by surveying Orthopaedic surgeons who treat patients with DDH. The survey assessed the timing of DDH presentation, resource availability, and current state of screening and diagnosis, which would help in the development of a DDH care pathway for India.
An online survey was distributed to Orthopaedic surgeons practicing in India via email and administered onsite to those attending the annual conference of the Pediatric Orthopaedic Society of India in 2019.
173 completed surveys were received from surgeons practicing in a predominantly urban setting. 68.8% of respondents had performed initial evaluations on children with DDH aged over 1 year in the past 12 months, and 49.1% had assessed children with DDH aged > 2 years on initial presentation. There was no consistent use of established guidelines, with only 30% of respondents stating that a care pathway was in place at their institution. However, 91.9% would support the implementation of a care pathway developed in India, to decrease the incidence of delayed diagnosis and facilitate earlier intervention. 85% of respondents had ready access to ultrasound scans and 95.4% had access to X-rays.
In India, there is still a large number of late-presenting cases of DDH, which could be improved with effective screening. The development of a care pathway for DDH in India is well-supported by Orthopaedic surgeons and may help decrease the incidence of late presenting cases; potentially improving outcomes, decreasing morbidity, and upskilling local practitioners.
我们通过对治疗发育性髋关节发育不良（DDH）患者的骨科医生进行调查，评估了印度DDH的筛查、转诊和治疗实践。该调查评估了DDH就诊的时间、资源可用性以及筛查和诊断的现状，这将有助于制定印度的DDH护理路径。
通过电子邮件向在印度执业的骨科医生发放在线调查问卷，并在2019年印度小儿骨科学会年会上对参会人员进行现场调查。
共收到173份来自主要在城市地区执业的外科医生的完整调查问卷。68.8%的受访者在过去12个月内对1岁以上的DDH患儿进行了初步评估，49.1%的受访者在初次就诊时对2岁以上的DDH患儿进行了评估。既定指南并未得到一致应用，只有30%的受访者表示其所在机构有护理路径。然而，91.9%的受访者支持实施印度制定的护理路径，以降低延迟诊断的发生率并促进早期干预。85%的受访者可以随时进行超声检查，95.4%的受访者可以进行X线检查。
在印度，仍有大量DDH晚期就诊病例，通过有效的筛查可以改善这种情况。印度骨科医生对制定DDH护理路径给予了大力支持，这可能有助于降低晚期就诊病例的发生率；有可能改善治疗效果、降低发病率并提高当地从业者的技能。
