J Korean Orthop Assoc.  2011 Dec;46(6):501-506.

An Analysis of Cases Referred from the Primary Healthcare Institution with Suspected Developmental Dysplasia of the Hip: A Prospective Study

• Cha SM
• Shin HD
• Lee SH
• Kim BK

Abstract

PURPOSE
A prospective, epidemiological investigation was performed in the patients referred to our hospital with suspected developmental dysplasia of the hip (DDH).
MATERIALS AND METHODS
Of the 121 patients referred from the primary healthcare institutions, with suspected DDH from January 2006 to December 2007, 82 patients who were able to be followed up for at least 2 years were enrolled in this study. Confirmation of the diagnosis was determined by patient history, physical examination, simple radiographs, and ultrasonography. Epidemiological investigation was performed in the total 82 cases which were referred from the primary healthcare institution and were confirmed as having DDH, and at least a 2-year follow up was performed in all these cases.
RESULTS
Of the 82 cases, 56 cases (68.3%) were within normal limits (W.N.L.), 15 cases (18.29%) were confirmed as having DDH, and 11 cases (13%) were diagnosed with several different diseases other than DDH. Compared to the total 82 cases, the percentage of females, presence of family history was statistically higher in the cases confirmed as having DDH. However, the incidence of breech presentation was not statistically different between all cases. 61 cases were referred by pediatricians and 21 cases were referred by orthopedic surgeons to the primary healthcare institution, and the diagnostic rate of DDH was statistically higher in the cases referred by orthopedic surgeons (p>0.05).
CONCLUSION
The rate of confirmation of the suspected diagnosis of DDH would hopefully increase through the establishment of physical examination protocols or radiologic study and systematic training programs that could be applied in the primary healthcare institution.

Keyword

developmental dysplasia of the hip; primary healthcare institution; epidemiology

MeSH Terms

Breech Presentation
Female
Follow-Up Studies
Hip
Humans
Incidence
Orthopedics
Physical Examination
Pregnancy
Primary Health Care
Prospective Studies

Figure

• 

  Figure 1 Bright-gray column is showing the data of total referred cases, dark-gray column means the cases of diagnosed as developmental dysplasia of hip (DDH). The ratio of female, and the presence of familial history are statistically higher in the cases, diagnosed to DDH (p=0.018, 0.034). No statistical difference was seen in the ratio of breech presentation (p=0.393). Between two groups, the most common chief complaint was different, but there was no statistical significance in analyzing the each chief complaint (p=0.174, 0.231). Hx., history; LLD, leg length discrepancy.

• 

  Figure 2 Bright-gray column is the data of cases referred from orthopedic surgeons, dark-gray column is the data of cases from pediatricians. The mean age in each cases was not statistically significant, but the ratio of confirmation to developmental dysplasia of hip (DDH) in each referred cases was statistically significant (p=0.171, 0.001).

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