Surveillance for Developmental Dysplasia of the Hip in India: Consensus Guidelines From the Pediatric Orthopaedic Society of India, Indian Academy of Pediatrics, National Neonatology Forum of India, Indian Radiological and Imaging Association, Indian Federation of Ultrasound in Medicine and Biology, Federation of Obstetric and Gynaecological Societies of India, and Indian Orthopaedic Association

被引:2
作者
Aroojis, Alaric [1 ]
Anne, Rajendra Prasad [2 ]
Li, Jacqueline [3 ]
Schaeffer, Emily [3 ]
Kesavan, T. M. Ananda [4 ]
Shah, Samir [5 ]
Patwardhan, Sandeep [6 ]
Karnik, Alka [7 ]
Thanawala, Uday [8 ]
机构
[1] Bai Jerbai Wadia Hosp Children, Dept Pediat Orthopaed, Acharya Donde Marg, Mumbai 400012, Maharashtra, India
[2] All India Inst Med Sci, Dept Pediat, Hyderabad, Telangana, India
[3] Univ British Columbia, BC Childrens Hosp, Dept Orthopaed, Vancouver, BC, Canada
[4] Govt Med Coll, Dept Pediat, Trichur, Kerala, India
[5] Samir Hosp, Vadodara, Gujarat, India
[6] Sancheti Inst Orthopaed & Rehabil, Dept Orthopaed, Pune, Maharashtra, India
[7] Max Nanavati Superspecial Hosp, Dept Ultrasonog, Mumbai, Maharashtra, India
[8] Thanawala Matern Home, Dept Gynaecol, Navi Mumbai, Maharashtra, India
关键词
Care pathway; Early detection; Hip dislocation; Screening; RISK-FACTORS; CLINICAL SIGN; DIAGNOSIS; LIMITATION; MANAGEMENT; ABDUCTION; CHILDREN; INFANTS;
D O I
10.1007/s13312-022-2577-3
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Justification When developmental dysplasia of the hip (DDH) is diagnosed during infancy, conservative management is often successful, with good long-term outcomes. In India, DDH is often not diagnosed until walking age and there are limited guidelines for its screening. Process A multidisciplinary Expert Group consisting of members of the Paediatric Orthopaedic Society of India, Indian Academy of Pediatrics, National Neonatology Forum of India, Indian Radiological and Imaging Association, Indian Federation of Ultrasound in Medicine and Biology, Federation of Obstetric and Gynaecological Societies of India, and Indian Orthopaedic Association worked collaboratively to develop surveillance guidelines for DDH. Objectives To enhance the early detection rate of DDH in India through development and implementation of a standardized surveillance care pathway, thus reducing the burden of late-presenting DDH. Recommendations Routine clinical hip examinations must be performed on all infants at birth and during immunization visits at these approximate time points: 6, 10, and 14 weeks; 6, 9, 12, 15, and 18 months of age. Assessments include Ortolani and Barlow tests for infants 14 weeks; and evaluation of limp in walking children. If clinical examination is abnormal or inconclusive, referral to orthopedics for further evaluation and management is recommended. In infants younger than 6 weeks with positive Barlow test but negative Ortolani test, hip ultrasound is recommended at 6 weeks of age. Infants must also be screened for DDH risk factors: breech presentation, family history of DDH, unsafe hip swaddling, and hip instability at any previous clinical examination. In infants with risk factors but normal clinical examination, further evaluation should include ultrasound taken no earlier than 6 weeks of age for infants younger than 14 weeks, ultrasound or X-ray for infants 14 weeks to 6 months of age, and X-ray for infants older than 6 months. Referral to an orthopedic surgeon is recommended if radiological tests are abnormal.
引用
收藏
页码:626 / 635
页数:10
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