THE COSTS OF LATE DETECTION OF DEVELOPMENTAL DYSPLASIA OF THE HIP

Debate currently exists regarding the economic viability for screening for developmental dysplasia of the hip in infants.A retrospective study of infant hip dysplasia over the period of 1998–2008 (36,960 live births) was performed to determine treatment complexity and associated costs of disease detection and hospital treatment, related to the age at presentation and treatment modality.179 infants (4.8/1000) presented with hip dysplasia. 34 infants presented late (>3 months of age) and required closed or open reduction. 145 infants presented at <3 months of age, 14 of whom failed early pavlik harness treatment. A detailed cost analysis revealed:131 early presenters with successful management in a pavlik harness at a cost of £601/child.34 late presenters who required surgery (36 hips, 19 closed/ 17 open reductions, 1 revision procedure) at a cost of £4352/child.14 early presenters with failed management in a pavlik harness requiring more protracted surgery (18 hips, 4 closed/ 14 open reductions, 7 revision...