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[Congenital luxation of the hip. A selective screening of newborn infants at a central hospital].

BACKGROUND
Various studies during the 1980s indicated that ultrasound examination of the hips in newborns might be a good supplement to clinical examination in early diagnosis of congenital dislocation of the hip (CDH).


MATERIAL AND METHODS
From 1993, a selective screening group of newborn infants with a positive Ortolani's/Barlow's test and/or anamnestic risk factors for CDH received an ultrasound examination using a modified Graf's method. Indications, results, treatment and clinical course were recorded consecutively over three years. Information about late diagnosed CDH (later than at four weeks of age) was recalled retrospectively with at least two years follow-up.


RESULTS
Of 3,690 newborns, 623 infants had increased risk of CDH. 621 of these were examined with ultrasound. Only half of the children with a positive Ortolani's/Barlow's test were found to have CDH in need of treatment on the ultrasound examination. 37 infants were treated with Frejka's abduction device. In this group, five children needed additional treatment with abduction splint due to CDH diagnosed on X-ray examination at five months of age. In addition one child with early diagnosed CDH was not treated until it was five months of age.


INTERPRETATION
Totally, we treated 38 children in the selective screening group. This is proportionally fewer infants than in other Norwegian studies. Nevertheless, none of the children in the selective screening group had late diagnosed CDH. We found that ultrasound examination of the hips is a useful supplement to clinical examination in early diagnosis of CDH.