Congenital dislocation of hip in the newborn: a postnatal survey

The results of a postnatal survey carried out for congenital dislocation of hip in children born at the Wellington Hospital maternity unit over a ten year period is presented. Of the 15,000 neonates born during this period, 91% underwent hip examinations. Abnormality was recorded 1.8% (n = 247) 78% (n = 192) of whom had clinically stable hips when re-checked seven to ten days later. In all, 60 children had unstable hips requiring definitive treatment, five of whom missed the neonatal screening and presented late. In this latter group, 77% (n = 46) had normal hips by six months of age following conventional splintage. Eight point two percent (n = 5) were unstable after six months of splintage, 5% (n = 3) were lost to follow-up, 1.6% (n = 1) presented late and in 8.2% (n = 5) the hip examination was either not done or instability not detected. We conclude that, in spite of the great awareness and known long term benefits of early neonatal hip examinations, late presentations because of missed examinations continue to be significant.