Department of Pediatrics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India.
Department of Orthopedics, University of British Columbia, Vancouver, BC, Canada.
Indian J Pediatr. 2022 Sep;89(9):911-915. doi: 10.1007/s12098-022-04200-5. Epub 2022 Jun 22.
Pediatricians play a key role in identifying neonates with hip instability or at risk for developmental dysplasia of the hip (DDH); however, the clinical practices related to screening and further management in India are unknown. A web-based survey was circulated to members of the National Neonatology Forum of India (NNFI). Of the 231 eligible responses, about 92% were from an urban setup. It was noted that 38% (88/231) had not diagnosed any DDH in the past 12 mo, 8% (17/224) had diagnosed cases beyond walking age, 50% (116/231) would pursue further evaluation in children < 3 mo with risk-factors and normal hip exam, 53% (122/229) were aware of hip-safe swaddling, 30% (68/226) were comfortable with performing Ortolani and Barlow maneuvers and < 50% (107/226) were aware of the current guidelines for the management of DDH. Almost all respondents (97.3%, 220/226) felt a need for a DDH care pathway for screening and early management in India. Thus, substantial deficits and variability in screening practices for DDH amongst pediatricians in India.
儿科医生在识别髋关节不稳定或发育性髋关节发育不良(DDH)风险的新生儿方面发挥着关键作用;然而,印度在筛查和进一步管理方面的临床实践尚不清楚。我们向印度国家新生儿学论坛(NNFI)的成员发送了一份网络调查。在 231 份符合条件的回复中,约 92%来自城市环境。结果表明,38%(88/231)在过去 12 个月中未诊断出任何 DDH,8%(17/224)在行走年龄后诊断出病例,50%(116/231)将对有危险因素且髋关节检查正常的 < 3 月龄儿童进行进一步评估,53%(122/229)了解髋关节安全襁褓法,30%(68/226)熟练进行 Ortolani 和 Barlow 手法,且 < 50%(107/226)了解 DDH 管理的现行指南。几乎所有(97.3%,220/226)受访者认为印度需要制定 DDH 筛查和早期管理的路径。因此,印度儿科医生在 DDH 筛查实践中存在大量缺陷和差异。