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. 2014 Aug;8(4):325-32.
doi: 10.1007/s11832-014-0599-7. Epub 2014 Jun 29.

The costs of late detection of developmental dysplasia of the hip

Timothy Woodacre  1 , A Dhadwal, T Ball, C Edwards, P J A Cox
Affiliations

The costs of late detection of developmental dysplasia of the hip

Timothy Woodacre et al. J Child Orthop. 2014 Aug.

Abstract

Purpose: Debate currently exists regarding the economic viability for screening for developmental dysplasia of the hip in infants.

Methods: A prospective study of infant hip dysplasia over the period of 1998-2008 (36,960 live births) was performed to determine treatment complexity and associated costs of disease detection and hospital treatment, related to the age at presentation and treatment modality. The involved screening programme utilised universal clinical screening of all infants and selective ultrasound screening of at-risk infants.

Results: One hundred and seventy-nine infants (4.8/1,000) presented with hip dysplasia. Thirty-four infants presented late (> 3 months of age) and required closed or open reduction. One hundred and forty-five infants presented at < 3 months of age, 14 of whom failed early Pavlik harness treatment. A detailed cost analysis revealed: 131 early presenters with successful management in a Pavlik harness at a cost of £601/child; 34 late presenters who required surgery (36 hips, 19 closed/17 open reductions, one revision procedure) at a cost of £4,352/child; and 14 early presenters with failed management in a Pavlik harness requiring more protracted surgery (18 hips, four closed/14 open reductions, seven revision procedures) at a cost of £7,052/child.

Conclusions: Late detection causes increased treatment complexity and a sevenfold increase in the short-term costs of treatment, compared to early detection and successful management in a Pavlik harness.

Discussion: Improved strategies are needed for the 10 % of early presenting infants who fail Pavlik harness treatment and require the most complex and costly interventions.

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References

    1. American Academy of Paediatrics. Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip (2000) Clinical practice guideline: early detection of developmental dysplasia of the hip. Pediatrics 105:896. http://pediatrics.aappublications.org/content/105/4/896.full.html. Accessed 1 July 2013 - PubMed
    1. Witt C. Detecting developmental dysplasia of the hip. Adv Neonatal Care. 2003;3:65–75. doi: 10.1053/adnc.2003.50016. - DOI - PubMed
    1. Garvey M, Donoghue VB, Gorman WA, O’Brien N, Murphey JF. Radiographic screening at four months of infants at risk for congenital hip dislocation. J Bone Jt Surg [Br] 1992;74(5):704–707. - PubMed
    1. Patel H, Canadian Task Force on Preventative Health Care Preventative health care, 2001 update: screening and management of developmental dysplasia of the hip in newborns. Can Med Assoc J. 2001;164:1669–1677. - PMC - PubMed
    1. Omeroglu H, Koparal S. The role of clinical examination and risk factors in the diagnosis of developmental dysplasia of the hip: a prospective study in 188 referred infants. Arch Orthop Trauma Surg. 2001;121:7–11. doi: 10.1007/s004020000186. - DOI - PubMed

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