Can parents be effective screeners in identifying developmental dysplasia of the hip? Review of a self-check guide

Abstract

Background: Infants have been screened for developmental dysplasia of the hip (DDH) since the 1960s. However, changes to the national screening programme in 2008 have reduced the surveillance of DDH following the removal of the 8-month infant hip check, leaving only the 6–8 week hip check as standard. Aim: The study was to ascertain if parents/carers could be effective screeners in the detection of infant DDH using a self-check guide. Design and setting: A self-check guide for DDH was developed to enlist parents as screeners. The guide highlights common signs used to alert to the possibility of DDH or hip dislocation. It was disseminated during 2008–13 by the Royal Berkshire NHS Foundation Trust in West Berkshire, through maternity services and health centres. Results: Of those infants referred to our clinic as a result of parental screening, 73% were ‘abnormal’; of these, 33% went on to treatment with splintage. The mean age of infants was 5.36 months, and 20% of positive findings were in infants aged 7 months or over at the time seen. None went on to have open surgery. These patients represented 5–10% of the overall group of DDH-positive patients. If left undiagnosed, they may have gone on to late presentation requiring surgery as a child, or undiagnosed acetabular dysplasia and possible surgical treatment in relatively early adulthood. Conclusion: Given the right guidance, parents could assist in detecting DDH in their infant.