DiFFICULTIES OF EARLY DIAGNOSIS AND TREATMENT OF CONGENITAL DISLOCATION OF THE HIP IN NORTHERN IRELAND

¹ Orthopaedic Research Department, Musgrave Park Hospital, Belfast, Northern Ireland

1. In Northern Ireland a campaign to eradicate congenital dislocation of the hip by neonatal demonstration of abnormal laxity and early splintage has been reviewed. The number of live births in the area covered is approximately 30,000 per annum.

2. The results to date suggest that the problem has been greatly over-simplified. The number of established dislocations has not fallen appreciably.

3. Failures have occurred both in early diagnosis and in early treatment.

4. To help close the diagnostic net all children should be screened again during the first year. Infants born by breech presentation and infants with a family history of dislocation should have radiographs taken in the early months, even if clinical tests are negative.

5. With regard to neonatal treatment, early splintage has failed to prevent established dislocation in about 2·4 per cent of the hips so treated. How to detect such resistant cases is an important problem.

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