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Is Routine Screening of Infants for Developmental Dysplasia of the Hip Still Needed?
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Posted on: 09/27/2007
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There has been some debate about the need for routine screening of all babies for a condition called developmental dysplasia of the hip (DDH). DDH describes a wide range of hip problems. The hip socket may be too shallow to hold the head of the femur (thighbone) in place. Or the femoral head may be be lined up properly with the hip socket.
After reviewing the current studies available, the U.S. Preventive Services Task Force (USPSTF) said routine screening for DDH wasn't needed. The authors of this article took a second look at the findings and disagreed. They offer their reasons for advising doctors to continue screening infants for DDH.
The USPSTF issued a statement saying that routine screening does not result in less surgery or better outcomes. The USPSTF also said that since many babies with DDH get better on their own without treatment, early identification isn't needed.
The authors point out that no true quality study has been done on this topic. For ethical reasons, it's not possible to compare a group of infants screened with a group who have not been screened. Withholding screening that could protect a child is not acceptable in our culture.
Three points were made in this article. First, many cases of DDH do resolve without treatment. But they don't all get better. Some children do need further treatment to avoid a bad outcome. Without screening, this can't happen.
Second, it is possible to detect an unstable hip early. The examiner must be trained and skilled in carrying out a special test for DDH called Ortolani’s maneuver. Early referral and treatment can make an important difference.
And finally, about one out of every 5,000 babies actually develops DDH later. It's not present at birth. This is called a late onset hip instability.
Such cases cannot be avoided with early, routine screening. But discontinuing screening can make a difference in other children. It should not be abandoned without clearer evidence. More study is needed before a final screening guideline can be developed fully.
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References:
Richard M. Schwend, MD, et al. Screening the Newborn for Developmental Dysplasia of the Hip. Now What Do We Do? In Journal of Pediatric Orthopaedics. September 2007. Vol. 27. No. 6. Pp. 607-610.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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