Hip instability in newborns in an urban community

A K Gupta1, S Kumari, P L Arora

  • 1Lady Hardinge Medical College and Shrimati Sucheta Kripalani Hospital, New Delhi, India.

Insights

Neonatal hip instability is common in New Delhi, affecting 18.7 per 1000 live births. Early detection through screening programs is recommended to prevent secondary complications in infants.

Area of Science:

  • Orthopedics
  • Pediatrics
  • Neonatal Care

Background:

  • Early recognition of congenital dislocation of the hip (CDH) is crucial for effective treatment and prevention of secondary changes.
  • Limited data exists on the incidence of CDH in India, necessitating local epidemiological studies.
  • A study was conducted in New Delhi to address this data gap.

Purpose of the Study:

  • To determine the incidence of neonatal hip instability in New Delhi.
  • To identify risk factors associated with neonatal hip instability.
  • To evaluate the natural progression and treatment outcomes of neonatal hip instability.

Main Methods:

  • A prospective study involving 6,029 consecutive newborns examined by orthopaedic and paediatric specialists.
  • Clinical examination for neonatal hip instability was supplemented with X-ray and ultrasonographic imaging.
  • Data collection focused on incidence, affected demographics, and hip stability over time.

Main Results:

  • Neonatal hip instability was detected in 18.7 per 1000 live births (148 hips in 113 newborns).
  • Subluxatable hips occurred in 12.1 per 1000, and dislocated hips in 0.82 per 1000 live births.
  • Female infants, breech presentation, and left hip involvement were associated risk factors; most hips stabilized within 20 weeks with conservative management, except in cases with other congenital abnormalities.

Conclusions:

  • Neonatal hip instability is a prevalent condition in New Delhi.
  • The findings support the initiation of a screening program to assess the incidence across India.
  • Early detection and intervention are vital for managing neonatal hip instability.
Abstract