The diagnosis and management of neonatal hip instability: results of a clinical and targeted ultrasound screening program.
This article reports the results of a neonatal hip screening program comprising clinical screening and targeted ultrasound performed by orthopaedic surgeons. Over 7 years, from 1995 to 2001, there were 15,397 live births in the authors' region. Seven hundred thirty-three babies (4.8% of births) were referred for hip ultrasound: 80% for risk factors and 20% for instability. Eighty-three babies (5.4/1,000) were splinted in a Pavlik harness. Three of these subsequently required surgery (1.9/1,000). Ten patients (0.65/1000) presented with hip dislocation after 12 weeks of age, nine of whom required open or closed reduction (0.56/1,000). From 1978 to 1985, when neonatal pediatricians clinically screened all babies, 18 babies presented late from 13,707 births (1.3/1000). Since the introduction of orthopaedic screening and targeted ultrasound, there has been a significant reduction in late diagnosis in the authors' institution.
Vane
Andrew G S
AG
Department of Orthopaedic Surgery, Dunedin Public Hospital, Dunedin, New Zealand.
Gwynne Jones
David P
DP
Dunbar
John D
JD
Theis
Jean-Claude
JC
D002675:Child, Preschool; D005260:Female; D006621:Hip Joint; D006801:Humans; D007223:Infant; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008403:Mass Screening; D014463:Ultrasonography