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Developmental Dysplasia of the Hip in a Developing Country. Rebuilding the Strategy for Early Diagnosis and Management.doc

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Developmental Dysplasia of the Hip in a Developing Country. Rebuilding the Strategy for Early Diagnosis and Management

Duni. Developmental Dysplasia of the Hip in a Developing Country Macedonian Journal of Medical Sciences. 2009 Sep 15; 2(3):205-208. doi:10.3889/MJMS.1857-5773.2009.0053 Clinical Science OPEN2ACCESS Developmental Dysplasia of the Hip in a Developing Country. Rebuilding the Strategy for Early Diagnosis and Management Artid Duni National Trauma Centre, Laprake, Tirana, Albania Abstract Background. Early diagnosis of developmental dysplasia of the hip (DDH) in our country, remains a major problem with about 40% of cases presenting after the walking age. Key words: Developmentaldysplasiaofthehip(DDH); Developing country; Strategy; Screen- ing; Early diagnosis. Material and Methods. In a district near the capital with 111000 habitants, and 900 new births per year, we applied an experimental chain of screening. Then we analyzed the general epidemiological indexes and the rate of early diagnosis. Our study was extended from 1999 to 2007 dividing in two periods (before and after January 2004) comparing the results in order to see the effectiveness of the new strategy applied after 2004. Correspondence: Artid Duni, MD National Trauma Centre, Laprake, Rr, Margarita Tutulani, P TID Ap10/3 Shk1, Tirana, Albania E-mail: aduni17@; aduni@abissnet.al Results. We treated 111 DDH cases from a total number of 8490 live births with an overall incidenceof 13‰. From55childrentreatedduring1999-2004, 20of themor36.3%wereabove one year of age at the beginning of treatment and only 35 of them (63.7%) have been treated under the age of one year. After 2004 we treated 56 children but 49 of them or 87.5% have been treated before one year of age and 7(12.5%) after this age. (p0.004) Received: 12-Mar-2009 Revised: 25-May-2009 Accepted: 27-May-2009 Online first: 15-Jul-2009 Conclusion. New strategies could change the reality of the early diagnosis and treatment of DDH in our country. Introduction centersandthesmallhealthcarespotsinthevillages disappeared breaking the chain