Diagnosing Developmental Dysplasia of Hip in Newborns Using Clinical Screen and Ultrasound of Hips-An Indian Experience.

AIM: To study the cost-effectiveness of clinical screen with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in newborns.

METHODS

Retrospective study (2006-14). Term newborns had (i) target scan at 6 weeks-family history of DDH or breech presentation-and (ii) early scan-abnormal clinical screen.

RESULTS

In all, 736 babies had USG scan. Five early scans (Graf's classification; three Type IIA, one Type IIC and one Type IIIB] and 15 target scans (Type IIA) were reported abnormal. All Type IIA DDH had subsequent 12 weeks' scans normal. Babies with Type IIIB and IIC had hip reduction surgery at 6 and 16 months of age, respectively. At cost 200 INR/scan, total 147 200 INR was incurred against two possible hip replacements prevented.

CONCLUSION

Universal clinical screen with USG of hip can aid in early diagnosis of DDH in newborns. Large population-based studies from developing countries need to look in its cost-effectiveness.