[Results of specific neonatal screening for congenital dysplasia of the hip at the Vicenza Hospital. A prospective study of subjects at risk].

The aim of the study was to evaluate the incidence of pathological neonatal hips in the community served by the central Vicenza local health authority and to establish a protocol to minimize demands on available equipment, staff and the family. From May 1992 to May 1993 all neonates at San Bortolo Hospital in Vicenza were subjected to specific clinical examination of the hip by staff experienced in neonatal care. Neonates then underwent ultrasound examination--catalogued according to Graf--if they presented risk factors (dynamic ultrasound test was omitted). The orthopaedic examination was carried out in all cases. The total number of neonates involved was 1939 (994 m., 945 f.). Of these, 142 (7.3%) underwent ultrasonography (60 m., 82 f.). Family history and breech delivery were the most frequent anamnestic risk factors justifying ultrasound examination while among objective risk factors the most frequent being a clicking sound. Considering the clinical and ultrasound findings the resulting overall incidence of pathological hips is 0.25%. So far, there have been no late cases of c.d.h. A screening protocol such as ours cannot realistically aim to identify all pathological hips, however the great majority can be diagnosed at this early stage. Resources comparable to those used for our study are available to many other local health authorities. Higher diagnostic standard depend closely on local health policy.