Clinical assessment of hip instability in the newborn by an orthopedic surgeon and a pediatrician

The aim of this study was to improve the rate of detection of hip instability in the neonate. Over a period of 3 years, a pediatric orthopedic surgeon and a neonatal pediatrician both examined 12,891 neonates. During the fourth year, 5,087 newborns were examined by a pediatrician only. Each examiner, working independently, found that 51 babies had neonatal hip instability. In an additional 25 babies, one examiner failed to detect this instability on initial examination. Finally, 36 babies judged to have stable hips at birth later gave cause for orthopedic treatment. These findings strongly suggest that screening should not be restricted to the neonate but should involve several sequential examinations.