Objective. To assess the effect of ultrasound screening on primary diagnosis, management, and prevalence of late cases of developmental dysplasia of the hip (DDH).Design. A randomized, controlled trial, including 11,925 newborn infants who were allocated to receive either general, or selective or no ultrasound screening in addition to the clinical examination. In the selectively screened group only infants with risk factors or clinical findings of DDH received an ultrasound examination. The infants were at least 27 months old at the conclusion of the study. Those with risk factors for DDH had a radiograph examination of the hips at 4.5 months of age.Results. The three study groups did not differ in terms of sex distribution or positive Barlow/Ortolani tests. General ultrasound screening resulted in a higher treatment rate than in either the selective or in the no ultrasound screening groups (3.4% vs 2.0% and 1.8%, P .0001). For infants not subjected to treatment, ultrasound screening resulted in a higher follow-up rate because of nonconclusive early findings (13%, 1.8%, 0%, respectively; P .0001). The prevalence of late subluxation or dislocation was lower for subjects assigned to general ultrasound screening than for those subjected to selective or no ultrasound screening, but the differences were not statistically significant (0.3, 0.7, 1.3 per 1000, respectively; P = .11, test for trend).Conclusion. The effect of ultrasound screening in reducing the prevalence of late DDH was at best marginal despite a considerable increase in diagnostic and therapeutic efforts.
展开▼
机译：目的。评估超声筛查对髋部发育不良（DDH）晚期病例的初步诊断，管理和患病率的影响。设计。一项随机对照试验，包括11,925名新生婴儿，除了临床检查外，他们还接受了常规，选择性或不超声检查。在选择性筛查组中，只有具有危险因素或DDH临床表现的婴儿接受了超声检查。研究结束时，这些婴儿的年龄至少为27个月。那些有DDH危险因素的人在4.5个月大时进行了X线检查。三个研究组在性别分布或Barlow / Ortolani阳性试验方面没有差异。普通超声筛查的治疗率高于选择性超声筛查或无超声筛查的患病率（3.4％vs 2.0％和1.8％，P <.0001）。对于未接受治疗的婴儿，由于早期发现尚无定论，因此超声筛查的随访率更高（分别为13％，1.8％，0％; P <.0001）。接受常规超声筛查的受试者的晚期半脱位或脱位的患病率低于接受选择性超声筛查或不进行超声筛查的受试者，但差异无统计学意义（分别为0.3、0.7、1.3 / 1000; P = .11，测试趋势）。结论。尽管在诊断和治疗上的努力大大增加，但超声筛查在降低晚期DDH患病率方面的作用至多是微不足道的。
展开▼
