Effects of developmental dysplasia of the hip screening program on the treatment strategies: A retrospective study from a tertiary care hospital in the southeast region of Turkey

Abstract

OBJECTIVE: The aim of this study was to investigate the effects of the developmental dysplasia of the hip screening program on the treatment procedures in a tertiary health care center. METHODS: We retrospectively reviewed all the DDH patients between 2012 and 2019 from the operating theatre records. The patients were separated based on the year of treatment. The rates of each treatment modality were determined respectively from 2012 to 2019, and Pavlik harness usage of the patients were queried. The changes in the rates of several surgical interventions after the start of screening program were identified. RESULTS: Between 2012 and 2019, 831 interventions were applied to 711 DDH patients. Closed Reduction (CR) is the least invasive treatment method, and it increased significantly from 20% to 46%. The rate of Open Reductions (OR) also increased from 3% to 9% at this time period, but it was statistically insignificant. Conversely, Pemberton-Salter Osteotomy (PSO) and Dega-Chiari Osteotomy (DCO) rates decreased significantly (41% to 28% and 9% to 0%, respectively). The rate of Pemberton- Salter osteotomy with femoral shortening (PSO-FS) rate decreased insignificantly from 27% to 20%. In patients that used Pavlik harness, the most common intervention was CR (83%). In CR group, the screened newborn rate increased more than two times from 2012 to 2019. CONCLUSION: The results of this study have shown that after the initiation of the screening program for DDH, less invasive treatment modalities such as CR and OR interventions increased, and major bony procedures such as PSO, PSO-FS and DCO interventions decreased. Furthermore, as the screening program advanced, CR rate and the use of Pavlik harness rate in CR interventions increased. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.