The recent publication of an independent medical audit carried out by Mr. Simon Thomas, Consultant Paediatric Orthopaedic Surgeon of Bristol Royal Hospital, into pelvic osteotomies carried out on children between the ages of one and seven with developmental hip dysplasia at Temple Street Hospital (TSH), Crumlin Hospital (CRH) and the National Orthopaedic Hospital Cappagh (NOHC) has answered some questions but has raised many more.
The Audit reviewed 497 cases at TSH and NOHC and 132 cases at CRH. The period for which the Audit was undertaken was between January 2021 and December 2023.
The Audit raised concerns about the indications for pelvic osteotomy in many of the cases at TSH/NOHC but did say that some of the pelvic osteotomies were reasonably indicated. Most children at TSH/NOHC underwent pelvic osteotomies using a novel technique. Mr. Richards said in his report that all 497 cases of children that had undergone pelvic osteotomy at NOHC/TSH between 2021-2023 require ongoing follow-up to skeletal maturity. He warned that any complications that have arisen from pelvic osteotomy must be acknowledged and discussed with the families, that there should be an assessment of the original decision making in any such cases based on appropriate radiological indices and clinical history informing the decision to operate.
Mr. Richards also advised that intermittent clinical and radiological follow-up should continue for all cases until skeletal maturity at 12-16 years of age to access for persisting acetabular dysplasia. This should be a matter of routine after pelvic osteotomy.
The HSE are putting in place a detailed plan to ensure that the 1,800 children and young adults who are affected are to be reviewed up to skeletal maturity. However, whether any children have had to undergo unnecessary and complex surgeries and whether their parents properly consented to such procedures remains to be confirmed.
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