LAUSR

Introduction Early detection of DDH can reduce the surgical morbidity in children. A risk based ultrasound (US) screening criteria was introduced which was audited to assess its impact on open surgical rate. Methodology All newborns born in the years 2014–2016 referred to the screening US service were included in the study. Screening criteria included breech presentation, Maternal/1stdegree relative History of DDH and Abnormal Clinical Exam. All newborns were investigated and treated with a standardized algorithm. A Comparison group of newborns referred in 2011–2013 was used. Referrals for surgical opinion were done based on abnormal clinical or radiographic findings. Results 494 newborns 6 weeks or younger were referred in screening group. 268 Patients were treated in harness. 42 were referred for surgical opinion. 17 required surgical treatment. 12 required EUA and arthrogram, 8 closed reduction, 11 pelvic osteotomy, 1 femoral osteotomy and 7 are currently being observed. In comparison prior to screening between 2011–2013 only 81 newborns 6 weeks or younger were referred of which 27 patients required open surgery. Conclusion There was a significant increase in outpatient but not surgical burden due to introduction of screening criteria. There was a marked improvement in early referrals.