{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:16:53Z","timestamp":1792275413582,"version":"4.4.0"},"reference-count":32,"publisher":"Scientific Scholar","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"\n Background & objectives:<\/jats:title>\n Developmental dysplasia of the hip (DDH), when detected early, can usually be managed effectively by simple methods. A delayed diagnosis often makes it a complex condition to treat. Late presentation of DDH is fairly common in developing countries, and there is scarcity of literature regarding the epidemiology and reason for late presentation. Through this study, we attempted to identify the reasons for late presentation of DDH in children more than 12 months of age.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Fifty four children with typical DDH and frank dislocation of hip in whom treatment was delayed for 12 months or more were included. Parents were interviewed with a pre-structured questionnaire and data were collected for analysis with Microsoft Excel 2016 and SPSS version 26.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Diagnostic delay was the most common reason for late presentation and was observed in 52 children (96.2%). The mean age at diagnosis was 24.7 months. The mean age at treatment was 37.3 months with a mean delay of 12.5 months from diagnosis and 22.1 months from initial suspicion. Physician-related factors contributed 55.3 per cent, while family and social issues accounted for 44.7 per cent of overall reasons for diagnostic and treatment delays.<\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusions:<\/jats:title>\n Late presentation of DDH in walking age is common. Physician- and family-related factors accounted for most of these cases. Failure or inadequate hip screening at birth by the attending physician is a common reason for late diagnosis. The family members were unaware about the disorder and developed suspicion once child started walking with an abnormal gait.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijmr.ijmr_3569_20","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T08:25:39Z","timestamp":1699518339000},"page":"403-411","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Causes of late-presenting developmental dislocation of the hip beyond 12 months of age: A pilot study"],"prefix":"10.25259","volume":"157","author":[{"given":"Ashok N.","family":"Johari","sequence":"first","affiliation":[{"name":"Children\u2019s Orthopaedic Centre, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritesh Arvind","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Christian Medical College & Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir Kumar","family":"Mahapatra","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Srirama Chandra Bhanja Medical College, Cuttack, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"John","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Christian Medical College & Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"R1-20241212","first-page":"238607","article-title":"The epidemiology and demographics of hip dysplasia","volume":"2011","author":"Loder","year":"2011","journal-title":"ISRN Orthop"},{"key":"R2-20241212","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1097\/bpo.0b013e31815a6091","article-title":"The prevalence of dislocation in developmental dysplasia of the hip in Britain over the past thousand years","volume":"27","author":"Mitchell","year":"2007","journal-title":"J Pediatr Orthop"},{"key":"R3-20241212","first-page":"896","article-title":"Committee on Quality Improvement, Subcommittee on Developmental Dysplasia of the Hip","volume":"105","year":"2000","journal-title":"American Academy of Pediatrics. Pediatrics"},{"key":"R4-20241212","first-page":"210","article-title":"Late presentation of developmental dysplasia of the hip in children from southwest India \u2013Will screening help?","volume":"37","author":"Rebello","year":"2003","journal-title":"Indian J Orthop"},{"key":"R5-20241212","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00264-007-0333-x","article-title":"Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip","volume":"32","author":"Dogruel","year":"2008","journal-title":"Int Orthop"},{"key":"R6-20241212","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1136\/archdischild-2013-303647","article-title":"Screening of selected risk factors in developmental dysplasia of the hip:An observational study","volume":"98","author":"Talbot","year":"2013","journal-title":"Arch Dis Child"},{"key":"R7-20241212","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s11832-012-0451-x","article-title":"The effect of Dega acetabuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age:Short- to middle-term follow-up","volume":"6","author":"El-Sayed","year":"2012","journal-title":"J Child Orthop"},{"key":"R8-20241212","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1136\/adc.60.5.407","article-title":"Congenital dislocation of the hip:Early and late diagnosis and management compared","volume":"60","author":"Dunn","year":"1985","journal-title":"Arch Dis Child"},{"key":"R10-20241212","first-page":"269","article-title":"Hip instability in newborns in an urban community","volume":"5","author":"Gupta","year":"1992","journal-title":"Natl Med J India"},{"key":"R11-20241212","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/BPO.0000000000001602","article-title":"Even experts can be fooled:Reliability of clinical examination for diagnosing hip dislocations in newborns","volume":"40","author":"Harper","year":"2020","journal-title":"J Pediatr Orthop"},{"key":"R12-20241212","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3109\/17453679108999228","article-title":"Why is congenital dislocation of the hip still missed?Analysis of 96,891 infants screened in Malm\u00f61956-1987","volume":"62","author":"Sanfridson","year":"1991","journal-title":"Acta Orthop Scand"},{"key":"R13-20241212","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1302\/0301-620X.91B2.21300","article-title":"The effectiveness of a programme for neonatal hip screening over a period of 40 years:A follow-up of the New Plymouth experience","volume":"91","author":"Myers","year":"2009","journal-title":"J Bone Joint Surg Br"},{"key":"R14-20241212","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/BPO.0000000000000903","article-title":"Does late hip dysplasia occur after normal ultrasound screening in breech babies?","volume":"39","author":"Morris","year":"2019","journal-title":"J Pediatr Orthop"},{"key":"R15-20241212","doi-asserted-by":"crossref","first-page":"e1914779","DOI":"10.1001\/jamanetworkopen.2019.14779","article-title":"Incidence of late-diagnosed hip dislocation after universal clinical screening in Sweden","volume":"2","author":"Wenger","year":"2019","journal-title":"JAMA Netw Open"},{"key":"R16-20241212","first-page":"315","article-title":"Validity and diagnostic bias in the clinical screening for congenital dysplasia of the hip","volume":"60","author":"Jim\u00e9nez","year":"1994","journal-title":"Acta Orthop Belg"},{"key":"R17-20241212","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.2106\/JBJS.M.00397","article-title":"Fifty-year follow-up of late-detected hip dislocation:Clinical and radiographic outcomes for seventy-one patients treated with traction to obtain gradual closed reduction","volume":"96","author":"Terjesen","year":"2014","journal-title":"J Bone Joint Surg Am"},{"key":"R18-20241212","doi-asserted-by":"crossref","first-page":"240","DOI":"10.5694\/mja15.01082","article-title":"Increase in late diagnosed developmental dysplasia of the hip in South Australia:Risk factors, proposed solutions","volume":"204","author":"Studer","year":"2016","journal-title":"Med J Aust"},{"key":"R19-20241212","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1136\/archdischild-2013-304143","article-title":"Swaddling and hip dysplasia:An orthopaedic perspective","volume":"99","author":"Clarke","year":"2014","journal-title":"Arch Dis Child"},{"key":"R20-20241212","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1302\/0301-620X.76B3.8175853","article-title":"Screening for congenital dislocation of the hip by physiotherapists. Results of a ten-year study","volume":"76","author":"Fiddian","year":"1994","journal-title":"J Bone Joint Surg Br"},{"key":"R21-20241212","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11832-014-0555-6","article-title":"Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip:The Austrian hip screening program","volume":"8","author":"Thallinger","year":"2014","journal-title":"J Child Orthop"},{"key":"R22-20241212","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1016\/S0140-6736(03)14957-4","article-title":"Effect of ultrasound screening on the rate of first operative procedures for developmental hip dysplasia in Germany","volume":"362","author":"von Kries","year":"2003","journal-title":"Lancet"},{"key":"R23-20241212","doi-asserted-by":"crossref","first-page":"335","DOI":"10.3109\/17453679908997820","article-title":"The natural history of hip abnormalities detected by ultrasound in clinically normal newborns:A 6-8 year radiographic follow-up study of 93 children","volume":"70","author":"Tegnander","year":"1999","journal-title":"Acta Orthop Scand"},{"key":"R24-20241212","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1302\/0301-620X.101B3.BJJ-2018-1331.R1","article-title":"What is the incidence of late detection of developmental dysplasia of the hip in England?:A 26-year national study of children diagnosed after the age of one","volume":"101-B","author":"Broadhurst","year":"2019","journal-title":"Bone Joint J"},{"key":"R25-20241212","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1002\/ebch.1891","article-title":"Cochrane review:Screening programmes for developmental dysplasia of the hip in newborn infants","volume":"8","author":"Shorter","year":"2013","journal-title":"Evid Based Child Health"},{"key":"R26-20241212","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1302\/0301-620X.99B9.BJJ-2016-1325.R1","article-title":"Late presentation of developmental dysplasia of the hip:A 15-year observational study","volume":"99-B","author":"Talbot","year":"2017","journal-title":"Bone Joint J"},{"key":"R28-20241212","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1007\/s43465-021-00409-2","article-title":"Screening of newborns and infants for developmental dysplasia of the hip:A systematic review","volume":"55","author":"Pandey","year":"2021","journal-title":"Indian J Orthop"},{"key":"R29-20241212","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1007\/s43465-021-00573-5","article-title":"Why the time is ripe for India to develop a national DDH screening programme","volume":"55","author":"Johari","year":"2021","journal-title":"Indian J Orthop"},{"key":"R30-20241212","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1007\/s43465-021-00526-y","article-title":"The incidence, diagnosis, and treatment practices of developmental dysplasia of hip (DDH) in India:A scoping systematic review","volume":"55","author":"Chand","year":"2021","journal-title":"Indian J Orthop"},{"key":"R31-20241212","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s43465-020-00188-2","article-title":"Swaddling practices in an Indian institution:Are they hip-safe?A survey of paediatricians, nurses and caregivers","volume":"55","author":"Pinto","year":"2021","journal-title":"Indian J Orthop"},{"key":"R32-20241212","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jcot.2011.11.001","article-title":"Risk factors and diagnosis of developmental dysplasia of hip in children","volume":"3","author":"Agarwal","year":"2012","journal-title":"J Clin Orthop Trauma"},{"key":"R33-20241212","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1007\/s43465-021-00537-9","article-title":"The evolution of DDH management in India","volume":"55","author":"Johari","year":"2021","journal-title":"Indian J Orthop"},{"key":"R34-20241212","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s43465-020-00233-0","article-title":"Developmental dysplasia of the hip:An examination of care practices of orthopaedic surgeons in India","volume":"55","author":"Hooper","year":"2021","journal-title":"Indian J Orthop"}],"container-title":["Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmr.IJMR_3569_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T23:06:23Z","timestamp":1751497583000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijmr.org.in\/causes-of-late-presenting-developmental-dislocation-of-the-hip-beyond-12-months-of-age-a-pilot-study\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmr.ijmr_3569_20","relation":{},"ISSN":["0971-5916","0975-9174"],"issn-type":[{"value":"0971-5916","type":"print"},{"value":"0975-9174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2020-08-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}}]}}