Current approach in the early detectionig of developmental dysplasia of the hip

Developmental dysplasia of the hip joint is the most frequent inherited malformation of the locomotorial system. A modern system of child health protection in primary health care is directed at the early detection and aplication of the most efficient therapeutic and preventive procedures. Research was performed on 300 infants referred for ultrasound examination of the hips with a clinical diagnosis :"contractura adductoria coxae". The results showed that two luxations were detected by clinical orthopedic check-up, and were confirmed by ultrasound. One luxation was detected by ultrasound, as it was not possible to obtain a clinical sign by Ortolani. All six subluxations (type II and D by Graf) and 82 dysplastic hips ( type II+. II-, IIB, IIC by Graf) were detected by ultrasound. The research showed that the clinical examination is of low sensitivity, specificity and liability, and therefore does not meet the criteria for screening for developmental dysplasia of the hip joint. In primary care it is still not possible to perform preventive measures for this disorder, and secondary prevention is directed by objective diagnosis ultrasound examinations. Nonselective screening for developmental dysplasia of hip is proposed.