Neonatal Hip Instability: Incidence, Diagnosis and Treatment at the University Hospital, Uppsala, 1960–1964 and 1970–1974

Abstract

Neonatal hip instability, its incidence, diagnosis and treatment, has been studied retrospectively for the periods 1960–1964 and 1970–1974. The respective populations for the two periods amounted to 13,065 and 16,274 children all born at the same hospital. During the first period 191 children (14 per mille) were referred from the maternity nard to the orthopaedic department with suspected hip instability; 109 (8.3 per mille) children were considered by the orthopaedic consultant to have unstable hips. During the second period the corresponding figure were 503 (31 per mille) referred to the orthopaedic department and 189 verified as unstable (11.6 per mille). During the first period, 177 children were treated with Frejka pillows for about 3 months, only 14 being left untreated. In seven children the initial treatment was completed with a plaster cast. The results were uniformly good. During the second period, 195 children were treated with a von Rosen-splint for G weeks followed by Frejka pillows for another 6 weeks (seven completed treatment with plaster); in 143 cases Frejka pillows were the sole treatment and 161 had no treatment at all. There was one primary plaster. The treatment resulted in normal hips in all but one girl. In the non-treated group three subluxations were verified after the neonatal period. There were seven “missed” cases (diagnosed after the first month of life) in the first population (0.5 per mille), 15 in the second (0.9 per mille). This difference is not statistically significant. The calculated incidence of dislocations if no treatment had been instituted in the neonatal period is 1.5 per mille in the first population, and 2.5 per milk in the second. The difference is not statistically significant.

Key Words:

• CDH
• hip instability
• neonatal
• incidence