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.