DOS 2018

DOS Kongressen 2018 · 271 Late diagnosis of developmental dysplasia of hip with dislocation in infants - why does it still occur? Uggi Balle, Christian Færgemann Department of Orthopaedic surgery, Odense University Hospital Background: Despite routinely screening of all new-borns in DK late-present- ing developmental dysplasia of the hip (DDH) with hip dislocation is still a rela- tively frequent diagnosis. Purpose / Aim of Study: To examine the causes of missed diagnosis in infants with DDH with dislocation. Materials and Methods: A retrospective study of all children with hip disloca- tion due to late-presentation dysplasia of the hip (defined as diagnosis after 3 months of age) treated at Odense University Hospital 2015-17. Data was extracted from the patient registration system. Findings / Results: Overall 16 infants were diagnosed with late-presenting DDH with dislocation in the study period. One child had bilateral dislocations. All infants had routinely postpartum screening made by either a trained midwife or a paediatrician. Nine infants were referred by their GP, 4 by a paediatric special- ist, and 3 by an orthopaedic surgeon. Only two infants had known disposing factor (breech presentation and family history of hip dysplasia). The median age at diagnosis was 1.2 year (range: 0.3-2.6). One infant with bilateral hip disloca- tion and waddling gait was ignored by the GP and finally referred at the age 1.6 years. Another infant was examined by the GP several times without taking any action although the child had been limping since she started walking. The dislo- cation was diagnosed at the age of 2.6 years. One patient was continuously ex- amined with ultrasound until an x-ray revealed the dislocation at age 0.9 years. One infant was examined by an orthopaedic surgeon at age 125 days without diagnosing the dislocation. The dislocation was diagnosed at age 2.3 years. Conclusions: Few infants with hip dislocation had known risk factors. Missing of the diagnosis occurs at all levels of the referral chain. Limping at walking de- but should be taken seriously either risk factors of DDH or not. 212.