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Increase in late diagnosed developmental dysplasia of the hip in South Australia: risk factors, proposed solutions

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Early detection and treatment of developmental dysplasia of the hip (DDH) in newborns is important because late diagnosis (later than 3 months of age) is associated with a significant risk of poorer outcomes. This includes increased likelihood of surgery, more invasive surgical procedures, longer hospital stays, and early osteoarthritis of the hip, as well as increased health care costs.1,2

We previously reported a worrying increase in the number of infants diagnosed between 3 and 18 months of age with DDH in South Australia; prospective data showed an incidence of late diagnosed DDH of greater than 0.7 cases per 1000 live births, or around 15 cases each year.3 This contrasts with the low rate of 0.22 per 1000 live births, or four to five cases per year, during the period 1988–2003,4 and has occurred despite continued routine physical examination screening of all neonatal hips. Reports from New South Wales5 and Western Australia6 confirm that the increased incidence of late diagnosed DDH is not limited to SA, but has been observed nationally.

The aim of our study was to determine whether there are identifiable perinatal risk factors associated with late DDH in babies born in SA since 2003, and to review the…