Newborn hip checks system failing to prevent late diagnoses

A recent study suggests the current system of testing newborns for hip problems is failing and is resulting in too many late diagnoses and corrective surgery.

Currently in England, all newborns routinely undergo a hip examination, but only those who are considered to be at risk or with known problems are offered a scan.

If diagnosed at an early stage, developmental dysplasia of the hip (DDH) can be treated through the use of a removable splint which is worn for up to three months. However, if left untreated for up to a year or more, hip dysplasia can result in a shortened leg, the risk of continuing hip pain, surgery, and potential long-term complications.

Author of the study and consultant orthopaedic surgeon at Southampton Children’s Hospital Alexander Aarvold, said if left untreated, hip dysplasia was “a significant public health issue” and the current approach had “failed to impact” on late diagnoses in babies.

He went on to say “The signs are easily missed. They can be subtle. Doctors, midwives and nurses may be doing the checks and if they are not used to seeing hip dysplasia, it is hard to pick up.”

The study looked at 754 cases of late diagnosis between 1990 and 2016, around 1.28 cases per 1,000 births.

The British Society for Children’s Orthopaedic Surgery’s Tim Theologis, said “This study has provided evidence that the current selective screening for neonatal hip dysplasia is ineffective and the percentage of infants diagnosed late is unacceptably high.”

However, Public Health England’s Professor Anne Mackie, said “Offering a universal scan can cause more harm and evidence shows that it can lead to 20 times more babies being unnecessarily treated compared to the UK programme.

“We know that wearing a splint in the crucial early months can affect the bond between mother and baby and can also cause avascular necrosis where the hip ‘dies’.”

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Posted by Karen Motley, Clinical Negligence Department, Chadwick Lawrence LLP (tonymay@chadlaw.co.uk ), medical negligence lawyers and clinical negligence solicitors in Huddersfield, Leeds, Wakefield and Halifax, West Yorkshire.

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