Late Diagnosis of Congenital Dislocation of the Hip

Abstract

A cohort of children presenting with clicking hips was studied in 2 districts. In 1 district any child with a clicking hip was treated as though the hip was dislocated (by splintage in abduction); in the other district no treatment was offered. None of the treated group later presented with a dislocated hip. Four children were found with dislocated hips among the untreated group. Another 4 children who were not treated because their hips appeared to be normal on the 2nd examination later presented with dislocated hips. Accuracy of diagnosis in all units might be improved if the examination of the newborn was carried out by a limited number of doctors who would thereby become more experienced. Further improvements would be made if any hip which clicked on examination was treated as an unstable hip and splinted in abduction.