Roof Mackenzie A, Gibon Emmanuel, Rios-Ruíz Gilberto, Castañeda Pablo
Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.
Department of Orthopaedic Surgery, Hospital Shriners Para Niños Cd. De México, Coyoacán, México.
J Pediatr Orthop. 2021 Aug 1;41(7):433-436. doi: 10.1097/BPO.0000000000001871.
We sought to determine if the age of patients presenting to a tertiary subspecialty hospital dedicated to pediatric orthopaedics has changed over the last 21 years and determine if a dedicated ultrasound-screening program implemented in 2006 made any difference.
We reviewed the hospital charts for 9299 patients diagnosed with developmental dysplasia of the hip (DDH) and determined the age at the time of presentation; this was a consecutive series of all patients presenting between 1998 and 2019. We determined the diagnosis and age from the chart, 8011 were female (86.15%), and 1288 were male (13.85%). The left hip was affected in 4588 cases (49.34%), the right hip in 1824 cases (19.62%), and there were 2887 bilateral cases (31.05%).
Over the 21 years, the mean age of presentation was 2.36 years (range, 0.1 to 17 y). In 1998, the mean age was 2.49 years (range, 0.1 to 16 y). In 2006, a dedicated ultrasound-screening clinic was instituted. The mean age decreased to 1.70 years in 2019 (range, 0.1 to 14 y). The mean age at presentation decreased significantly from 2.65 years, between 1998 and 2005, to 2.19 between 2006 and 2019 (P=0.0067).
The implementation of a dedicated ultrasound-screening protocol was significantly correlated with a decrease in the mean age of diagnosis of DDH. The results of treatment of DDH are known to be better the sooner the diagnosis is made. Given that the age of presentation remains a challenge, especially in developing countries, a dedicated ultrasound-screening program is one step to improve our ability to detect DDH in patients at a younger age.
Level IV-diagnostic.
我们试图确定在过去21年里，前往一家专注于小儿骨科的三级专科医院就诊的患者年龄是否发生了变化，并确定2006年实施的专门超声筛查项目是否产生了任何影响。
我们查阅了9299例被诊断为发育性髋关节发育不良（DDH）患者的医院病历，并确定了就诊时的年龄；这是1998年至2019年间所有就诊患者的连续系列。我们从病历中确定诊断和年龄，8011例为女性（86.15%），1288例为男性（13.85%）。左侧髋关节受累4588例（49.34%），右侧髋关节受累1824例（19.62%），双侧受累2887例（31.05%）。
在这21年中，就诊的平均年龄为2.36岁（范围为0.1至17岁）。1998年，平均年龄为2.49岁（范围为0.1至16岁）。2006年，设立了专门的超声筛查诊所。2019年平均年龄降至1.70岁（范围为0.1至14岁）。就诊时的平均年龄从1998年至2005年的2.65岁显著降至2006年至2019年的2.19岁（P=0.0067）。
实施专门的超声筛查方案与DDH诊断平均年龄的降低显著相关。已知DDH的诊断越早，治疗效果越好。鉴于就诊年龄仍然是一个挑战，特别是在发展中国家，专门的超声筛查项目是提高我们在更年轻患者中检测DDH能力的一步。
IV级诊断性。
