PubMed · 4502872
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
N D Weir. 1972. Congenital hip dislocation.. https://pubmed.ncbi.nlm.nih.gov/4502872/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
OBJECTIVE: The early diagnosis of neonatal hip instability is well recognized in preventing possible late developmental dysplasia of the hip. The optimal scheme of its diagnosis is essential. The role of combined approach of clinical and ultrasonographic evaluation of hip instability in newborns is evaluated in the present study. METHODS: Hips of 9030 consecutive neonates were examined independently by clinical and ultrasonographic means, separately by neonatologists and orthopedic surgeons, without initial sharing of information. When hip pathology was diagnosed by one of the modalities and missed by another, re-examination was performed. The rate of initially undiagnosed, clinically or ultrasonographically unstable hips and the 1-year follow up of the effected newborns were recorded. RESULTS: Instability was diagnosed in 1.4% of all hips, but only 63% of unstable hips were diagnosed on the initial clinical examination. In the remainder, the clinical pathology was established on clinical re-examination after the sonographic abnormality was recognized. Similarly, but to a much lesser extent, sonographic pathology was detected only on the re-examination in 5% of the clinically unstable hips. Although the overall initial under-diagnosis rate of hip instability was 0.6% of all hips, the rate for treated hips was 0.1%. CONCLUSION: These data should be taken into consideration in planning an efficient DDH screening policy.
Explore the source record for details and available documents.
Between 1992 and 1997, we undertook a prospective, targeted clinical and ultrasonographic hip screening programme to assess the relationship between ultrasonographic abnormalities of the hip and clinical limitation of hip abduction. A total of 5.9% (2 of 34) of neonatal dislocatable hips and 87.5% (7 of 8) of 'late' dislocated hips seen after the age of six months, presented with unilateral limitation of hip abduction. All major (Graf type III) and 44.5% of minor (Graf type II) dysplastic hips presented with this sign. Statistically, bilateral limitation of hip abduction was not a useful clinical indicator of underlying hip abnormality because of its poor sensitivity, but unilateral limitation of abduction of the hip was a highly specific (90%) and reasonably sensitive sign (70%). It was more sensitive than the neonatal Ortolani manoeuvre, which has been considered to be the method of choice. It was, however, not sensitive enough to be of value as a routine screening test in developmental dysplasia of the hip. We consider unilateral limitation of hip abduction to be an important clinical sign and its presence in an infant over the age of three to four months makes further investigation essential.