Development and implementation of an interdisciplinary one-stop clinic for infant hip dysplasia: A pilot study

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-02-12 DOI:10.1016/j.clinsp.2026.100864

Patricia Moreno Grangeiro , Giovanna Braga Motta , Natasha Vogel Majewski Rodrigues , Daniel Frank Liggio , Cristiane Aun Bertoldi , Roberta Coimbra , Ina Fialho Zürcher , Yasmin Estefanía González Herrera , Moisés de Freitas Laurentino , Lisa Suzuki , Valdenise Tuma Calil , Nei Botter Montenegro , Giovanni Guido Cerri , Tarcísio Eloy Pessoa de Barros Filho , Werther Brunow de Carvalho , Roberto Guarniero

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引用次数: 0

Abstract

Objectives

The authors hypothesized that establishing a one-stop clinic for the management of Developmental Dysplasia of the Hip (DDH) at our institution would enhance screening procedures, referral processes, patient compliance, early diagnosis, and timely treatment for this condition. To inform clinical practice, the authors conducted a collaborative development of flowcharts for evidence-based patient care protocols, based on the Graf method and patient journey optimization.

Methods

A weekly DDH clinic was established in a tertiary/quaternary public teaching hospital in Brazil, integrating pediatrics, radiology, and orthopedics. Flowcharts were collaboratively designed during ten interdisciplinary meetings. As a pilot study, the authors included an initial cohort involved in an observational retrospective study during the period from October 2023 to December 2024.

Results

A novel system of grouping Graf types and subtypes was presented, accompanied by a treatment algorithm and phased therapeutic approach, based on the underlying hip pathology and immediate therapeutic requirements to promote hip centralization and acetabular development. A total of 98 infants were examined at the clinic during the specified period, with 22 receiving non-surgical treatment utilizing the Pavlik harness.

Conclusion

The establishment of a one-stop DDH clinic demonstrated a successful interdisciplinary approach, contributing to early diagnosis and effective treatment of DDH. The collaborative development of flowcharts facilitated the standardization of patient management protocols. Continued refinement of screening procedures and data collection methods is necessary to optimize care and inform future research on DDH management.

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发展和实施婴幼儿髋关节发育不良的跨学科一站式诊所：一项试点研究

目的：作者假设在我院建立一站式诊所来管理髋关节发育不良（DDH），将加强筛查程序、转诊流程、患者依从性、早期诊断和及时治疗。为了为临床实践提供信息，作者基于Graf方法和患者旅程优化，进行了循证患者护理方案流程图的合作开发。方法在巴西某三级/四级公立教学医院建立每周一次的DDH门诊，集儿科、放射科、骨科为一体。流程图是在十次跨学科会议期间共同设计的。作为一项试点研究，作者在2023年10月至2024年12月期间纳入了一项观察性回顾性研究的初始队列。结果提出了一种新的Graf类型和亚型分类系统，并根据髋关节潜在病理和当前治疗需求，提出了一种治疗算法和分阶段治疗方法，以促进髋关节集中和髋臼发育。在指定期间，共有98名婴儿在诊所接受了检查，其中22名接受了使用Pavlik安全带的非手术治疗。结论建立一站式DDH门诊是一种成功的跨学科方法，有助于DDH的早期诊断和有效治疗。流程图的协作开发促进了患者管理方案的标准化。继续完善筛查程序和数据收集方法对于优化护理和为DDH管理的未来研究提供信息是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.