Avoidable injuries in the treatment of developmental dysplasia of the hip: a 34-year retrospective analysis of compensation claims in Finland.

AIMS: This study aimed to evaluate all compensation claims related to the management of developmental dysplasia of the hip (DDH) in Finland between 1 January 1987 and 31 December 2020, with a particular focus on cases compensated as avoidable treatment injuries. A secondary aim was to identify the underlying causes of these adverse events to support the prevention of similar incidents in the future.

METHODS

We conducted a retrospective review of all compensation claims and decisions made by the Finnish Patient Insurance Centre (PIC) concerning management of DDH over a 34-year study period. We used data from the national care register (HILMO) to extrapolate the number of children aged under 15 years who received treatment for DDH in Finland between 1 January 1987 and 31 December 2020. We then assessed the nationwide risk of compensated treatment injuries of DDH.

RESULTS

During the study period, 55 patients filed compensation claims related to the management of DDH, of whom 43 received compensation as an avoidable treatment injury, with a calculated incidence of 2.4 per 1,000 DDH patients (95% CI 1.7 to 3.2). Delayed diagnosis was the most common reason for compensation (35/43): 23 cases were missed in hospitals; 21 in child welfare clinics; and nine were missed in both a hospital and a child welfare clinic. The most common reason for delayed diagnosis (20/35) was the failure to recognize typical clinical findings associated with DDH.

CONCLUSION

The number of compensated treatment injuries in the management of DDH was low in Finland, with most cases resulting from delayed diagnosis.