Neonatal hip instability: results and experiences from ten years of screening with the anterior-dynamic ultrasound method

Abstract

AIM: To record the results and experiences from a 10-y screening period with the anterior-dynamic ultrasound method for detecting neonatal hip instability. METHODS: An ultrasonographic improvement of the Palmén/Barlow test was used. The screening programme included 22,047 newborns. Decisions about treatment were made solely on the ultrasound result. RESULTS: It was found that 175 infants (7.9/1000) had at least one unstable hip--dislocated or dislocatable. Dislocated hips were found in 1.1/1000. Dislocatable hips were found in 6.8/1000 but only 1.1/1000 needed treatment. The total frequency of treatment was 2.2/1000. All cases but one were diagnosed before discharge from the maternity ward. The rate of surgery was 0.1/1000 newborns. Girls were more affected than boys, by a ratio of 3:1. Among the affected hips 64.4% were a left hip. CONCLUSION: Neonatal hip instability is always present at birth and can be diagnosed immediately after birth. We have no indications that instability can appear at a later stage. The anterior-dynamic ultrasound screening programme is an efficient tool to diagnose neonatal hip instability and to decide when to begin treatment.