{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:58:58Z","timestamp":1787893138064,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the incidence, clinical features and timing of initial treatment of early\u2010 and later\u2010presenting developmental dysplasia of the hip (DDH) in infancy in the context of a risk\u2010based selective ultrasound screening programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective observational study of infants born at a tertiary perinatal centre in Melbourne, Australia, between July 2016 and June 2020 and treated for DDH up to 18\u2009months of age at a tertiary paediatric centre. The incidence of DDH was calculated for early\u2010 and later\u2010presenting cases. Clinical features and ultrasound indications were analysed using multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 192 infants with DDH requiring treatment, 100 (52%) of which were not detected by universal neonatal hip examination and selective ultrasound screening based on risk factors (overall incidence 6.3 per 1000 livebirths). The median age at which treatment was commenced was delayed by 8\u2009weeks for the later\u2010presenting group compared to those detected through screening (16.7 vs. 7.9\u2009weeks, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Skin crease asymmetry was associated with later presentation (adjusted odds ratio (aOR) 44.03, 95% confidence interval (CI) 9.99\u2013333), whilst breech presentation (aOR 0.08, 95% CI 0.02\u20130.26) and Barlow\/Ortolani test positivity (aOR 0.06, 95% CI 0.01\u20130.25) were associated with early presentation. Only 39 (1.45%) infants receiving a screening ultrasound had DDH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Approximately half of all infants with DDH were not detected by combining risk\u2010based selective ultrasound screening with neonatal clinical findings, highlighting the failure of this screening method to reliably detect a significant proportion of dysplastic infant hips.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16472","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T07:20:56Z","timestamp":1691392856000},"page":"1146-1151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Neonatal clinical examination and selective ultrasound screening are not reliable for the early diagnosis of hip dysplasia: A retrospective cohort study"],"prefix":"10.1111","volume":"59","author":[{"given":"Mitchell D","family":"Johnson","sequence":"first","affiliation":[{"name":"Neonatal Services Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Neonatal Medicine Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Kuschel","sequence":"additional","affiliation":[{"name":"Neonatal Services Royal Women's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Donnan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Orthopaedics Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Gait Lab and Orthopaedics Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-3107"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5402\/2011\/238607"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ebch.1891"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0b013e3283415927"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.4.180019"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2012.06110.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B3.BJJ-2018-1331.R1"},{"key":"e_1_2_8_9_1","unstructured":"Murdoch Children's Research Institute.New Initiative to Improve Outcomes for Children with Hip Dysplasia. Melbourne: The Institute; 2022. Available from:https:\/\/www.mcri.edu.au\/news-stories\/new-initiative-improve-outcomes-children-hip-dysplasia[accessed 1 May 2023]."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15111"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4388-5"},{"key":"e_1_2_8_12_1","first-page":"186","article-title":"Treatment of developmental dysplasia of the hip with the Pavlik harness: Factors for predicting unsuccessful reduction","volume":"10","author":"Inoue T","year":"2001","journal-title":"J. Pediatr. Orthop. B"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2017.05.002"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.27638"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.12.180056"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001602"},{"key":"e_1_2_8_17_1","first-page":"1021","article-title":"Enhanced detection services for developmental dysplasia of the hip in Scottish children, 1997\u20102013","volume":"103","author":"McAllister DA","year":"2018","journal-title":"Arch. Dis. Child."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200995"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-019-02529-w"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.2008.02575.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199005000-00007"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.070870"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.16472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T12:43:38Z","timestamp":1696941818000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.16472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,7]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/jpc.16472"],"URL":"https:\/\/doi.org\/10.1111\/jpc.16472","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,7]]},"assertion":[{"value":"2023-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}