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Referral criteria recognition of screeners in the Danish screening programme for hip dysplasia


Hans-Christen Husum1, 4, Janus Laust Thomsen2, Søren Kold1, Rikke Damkjær Maimburg3, 4 & Ole Rahbek1, 4

1) Interdisciplinary Orthopaedics, Aalborg University Hospital, 2) Centre for General Practice at Aalborg University, 3) Department of Gynaecology and Obstetrics, Aarhus University Hospital, 4) Danish Paediatric Orthopaedic Research, Denmark

Dan Med J 2022;69(2):A01210098


INTRODUCTION. The aim of this study was to review risk factors used in the current Danish screening programme for developmental dysplasia of the hip (DDH) and the self-reported recognition of these risk factors among midwives, general practitioners (GP) and GPs in training.

METHODS. A survey of regional DDH referral guidelines was conducted through online regional guideline databases. Furthermore, risk factors used as referral criteria for DDH were compared across regions.

Using an online survey, we asked midwives, GPs and GPs in training to identify which of six risk factors for DDH were currently featured as referral criteria for specialised DDH examination in the referral guidelines of their employment region. Answers were compared with the DDH referral guidelines of the responders’ employment region.

RESULTS. We collected 178 survey responses and 11 local and regional DDH referral guidelines. Six risk factors were identified from referral guidelines (breech presentation, oligohydramnios, family history of DDH, clubfeet, twins and premature birth). Overall, correct answer percentages for currently used risk factors for DDH as specified in the corresponding regional guidelines were: 96% (breech presentation), 90% (family history of DDH), 66% (twins), 63% (premature birth), 34% (clubfeet) and 29% (oligohydramnios).

CONCLUSIONS. This study found variation in the referral criteria among Danish regional DDH referral guidelines and an overall high level of recognition for two out of six referral criteria but a low level of recognition for the remaining four.

FUNDING. The authors received no financial support for the research conducted in preparation of this article.


Developmental dysplasia of the hip (DDH) is a hip malformation disorder ranging from mild structural abnormalities of the acetabulum or femur to complete hip dislocation. DDH has an annual incidence rate of 0.7-1.0% of newborn children [1, 2] and is the most common orthopaedic disorder in neonates.A selective ultrasound screening programme for DDH has been implemented in all regions of Denmark. The programme consists of universal clinical screening by midwives and general practitioners (GPs) according to the national recommendations from the Danish Health Authority [3] followed...
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Dan Med J 2022;69(2):A01210098


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