Final Report for 2017 DDH Educational Course

Hip Dysplasia is four times more common in Ecuador than any other South or Central American country. IHDI has initiated efforts to improve this in Ecuador with education for the public and for health care workers. Many children still undergo traditional swaddling as shown in the photo. Dr. Price and MAB member, Pablo Castaneda (photo) helped organize and participate in a program to teach early diagnosis and treatment. They also met with local physicians to help determine the potential of a public relations campaign to influence swaddling practices.

Here is a review of that program.


Final Report For POSNA SEOT COUR DDH Educational Course.

Course title:  Curso POSNA/Ortopedia Infanti.  Developmental Dysplasia of the Hip.

Sponsors:  POSNA, Sociedad Ecuatoriana de Ortopedia Y Traumatologia. International Hip Dysplasia Institute, Orlando, FL.

Local hosts:  Telmo Tapia SEOT, Ivan Vallejo SEOT Vice President.

SEOT President:  Dr. Esteban Santos, Quito.

Location: Centro de Convenciones Mall del Rio, Hotel Four Seasons,  Cuenca, Ecuador

Date October 6, 2017

The conference was a pre course to the National meeting in Ecuador.


  • Telmo Tapia MD, former POSNA COUR scholar 2012. SEOT Cuenca Ecuador
  • Chad Price MD, International Hip Dysplasia Institute. IHDI, Orlando FL.
  • Pablo Casaneda MD, New York University, Hospital for Joint Diseases
  • Richard Schwend MD, Children’s Mercy Hospital.
  • Steve Santora MD Shriners Hospitals for Children, Salt Lake City.
  • Carlos Leal MD, SEOT
  • Carlos Rios, SEOT.
  • Jesus Sevillano, SEOT
  • Arturo Almazan, SEOT

Background:  Hip Dysplasia is an unsolved problem in Ecuador.  Tight swaddling is still practiced in many regions of the country.  There is often inadequate public education to discourage excessively tight swaddling.  Early detection is not universally practiced by primary care providers.  There is not a quick response system to provide early and safe treatment for infants who are detected.  As a result, treatment is often delayed or or non existant.  When surgical treatment is provided, it may be too late or not performed correctly.  SEOT, POSNA and IHDI have partnered to provide this one day educational Pre- course to the SEOT national meeting.  Target audience was general orthopaedic surgeons, pediatric orthopaedic surgeons, pediatricians and other providers.  POSNA provided funding for simultaneous translation, AV, scholarships, and advertising expenses.  IHDI provided faculty and hip models.  Since the DDH one day meeting preceded the SEOT national meeting, there was economy in the facility and a larger pool of potential attendees.


Approximately 100 participants were in attendance.  There was simultaneous translation so the pace of the meeting was appropriate.  Case discussions were lead by US faculty.  Chad Price introduced many of the teaching methods of IHDI.  Audience participated very well.


  • Well organized course preceding SEOT National meeting for high visibility
  • Very experienced faculty including Steve Santora MD
  • Case discussions by Dr. Chad Price
  • Hip ultrasound exam on infant by Dr. Pablo Castenada. Used portable probe and cell phone
  • Schwend brought in 3D printed plastic models of adolescent DDH, showing pathology and osteotomy
  • Simultaneous translation
  • Primary care physicians also involved. Feedback was that it was outstanding course and met the needs of the particiapants
  • Meeting was within budget.


This was a one-day course dedicated to developmental dysplasia of the hip.  Since it preceded the SEOT national meeting, facilities, faculty and attendees were more efficiently organized.  SEOT, POSNA and IHDI worked cooperatively to create this meeting.  Its success depended on a strong local host, Telmo Tapia, 2012 IPOS COUR scholar.  POSNA provided funding for simultaneous translation, scholarships, AV, plastic models.


  • Continue this model of pre-course attached to their national meeting.
  • Future funding is very helpful for translation, AV scholarships, models, advertising.
  • We need specific feedback and evaluations from the participants. Standardized precourse and postcourse evaluation system should be very helpful to standardize the quality of the learning experience.
  • Use same model to develop trauma course at future national meeting. Invite faculty from SLAOTI.
  • Hands on practical teaching, actual ultrasound demonstration, Plastic 3D Models are very useful teaching methods

Schwend  10/20/17

Despite educational attempts, cultural factors continue to dominate family decision to swaddle infant.

Dr. Pablo Castanada demonstrating ultrasound assisted Physical exam of an infant.  Portable transducer and smart phone can be useful to perform DDH screening.

Our gracious hosts:  Telmo and Ximena Tapia, Cuenca, Ecuador.  Dr. Tapia was 2012 COUR IPOS visiting scholar.


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