Developmental dysplasia of the hip: incidence and treatment outcomes in the Southeast of Ireland.

Abstract

The incidence of developmental dysplasia of the hip (DDH) in the Republic of Ireland is unknown. It has been shown by previous Irish studies that effective screening methods for DDH are not widely practiced. The effect of this on treatment outcomes is unknown. The aim of this study was to estimate the incidence and treatment outcomes of DDH in the Southeast of Ireland. In a retrospective study, all cases of DDH in children born in 2009 were identified using the outpatient clinic database. We defined an early and late diagnosis as those treated before and after three months, respectively. We defined the operative incidence as those who required open surgery. Fifty-six cases of DDH were diagnosed giving an incidence of 6.73 per 1,000 live births. 58.9% (n = 33) were referred to the clinic and began treatment early, while 41.1% (n = 23) presented late. The incidence of operative procedures was 1.08 per 1,000 live births. The incidence of those requiring surgery was higher in the late diagnosis group. Our overall incidence rate of 6.73 per 1,000 live births in 2009 is similar to other international studies. Worryingly our incidence of 2.77 per 1,000 having late diagnosis and 1.08 per 1,000 live births requiring open surgery was higher. Despite screening with clinical examination, the percentage of late diagnosis remains high. There is a need for the development of a national screening policy with greater use of ultrasound screening to improve current practices.