ULTRASONOGRAPHIC HIP SCREENING IN THE BREECH-BORN NEONATES

Felc Z*1 , Ilijas-Trofenik A1 , Kotnik M2 , Weber V3

1Neonatal Unite, 2Department of Ortopaedics, 3Department of Gynaecology and Obstetrics, General Hospital, Celje, Slovenia

 

Objective: Breech presentation is considered to be a risk factor for congenital dysplasia of the hip. The purpose of this retrospective study was to recognize if ultrasonographic hip screening in the breech-born neonates  coould be a good supplement to clinical examination in early diagnosis of congenital dysplasia of the hip.

Methods: Throughout 72 months ending december 1997 the hips of each of 11.268 consecutive neonates (445 breech-born: 203 boys, 242 girls) were examinated clinically by Ortolani-Barlow procedure and sonographically according to Graf¡¯s technique by skilled pediatricians, in close co-operation with orthopedic surgeons on the second day after birth. The ultrasonographic screening according to Graf¡¯s: hips of type Ia and Ib are not pathologic, hips of type IIa need an early control examination; and hips of IIg, IIIa and IV require therapy. 

Results: Statistically, breech-born neonates showed signitificantly more of hips of type IIa, IIg, IIIa and IV in comparisson with non-breech group (49.7 vs 26.8%; P<0,001). In the breech group we found ultrasonographically abnormal hips more frequent in the girls (P<0,001), right sided (P<0,05) and in neonates with higher birthweight (P<0,01). Of 445 breech-born neonates only 66 (15%) showed unstable hips clinically (P<0,001).  In all cases the final outcome after adequate treatment show a hip joint without any abnormalities.

Conclusions: Ultrasonographic screening of the hips in breech-born neonates is a useful supplement to clinical examination in early diagnosis of congenital dysplasia of the hip.

 

 
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