[Introduction of the Graft's method in a county hospital. Experiences with and results of ultrasonography in diagnosis of congenital hip joint dysplasia].

From May 1992 to December 1993 we examined 506 hips of newborns by means of ultrasound. The Graf method was introduced at our department in order to reduce the use of X-rays to diagnose congenital dysplasia of the hip to a minimum, and to increase the accuracy of early diagnosis. We cooperated closely with the clinicians. We examined "high-risk" newborns. From 2,434 consecutive births over a period of 20 months, we examined 253 babies because of family history (55%), breech delivery (38%), positive Ortolani test (4%) and other reasons (3%). 46 babies (18%) were successfully treated with a pillow. Our results differ from Graf's on several points. We missed one child with a dysplastic hip. In this case the ultrasound examination was normal at birth, but the child was referred for renewed radiographic examination because of clinical findings that suggested congenital dysplasia of the hip. Like many other authors, we conclude that ultrasound is a safe and reliable method of detecting early congenital dysplasia of the hip. During and after the observation time we have changed our routines to fit our results. At the beginning we performed only one ultrasound examination, now two are performed as a routine.