The role of public health nurses in the detection of developmental dysplasia of the hip

Aims 

Our study aimed to quantify the role played by public health nurses (PHNs) in the detection of cases of developmental dysplasia of the hip (DDH) not identified by existing national screening processes. 

Methods 

We conducted a review of all children diagnosed with DDH in our centre over an 18-month period. Referral details and general clinical information were then analysed for all late diagnoses, defined as later than three months of age. 

Results 

339 infants were diagnosed with at least some degree of dysplasia over the study period, implying an annual incidence of 31.3 cases per 1,000 live births. 86 of these (25.4%) were late diagnoses. 67.9% of referrals of late cases originated with a PHN. A small subgroup of late diagnoses (n = 8) presented with frank hip dislocation. 

Conclusion 

The proportion of DDH diagnoses made after three months of age remains significant. Our findings suggest that PHN reviews in the first year of life constitute an important ‘safety net’ in expediting the diagnosis of DDH in babies not identified by existing national screening processes. Quality improvement and training interventions would be of value in further supporting this role.