[Primary ultrasonic diagnosis of congenital hip dysplasia in neonates at the Senta Hospital].

INTRODUCTION: Congenital hip dislocation is an abnormality which has not been managed in the period of early infantile period. However, clinical and ultrasound screening performed in the first days of life after birth at the Labor and Delivery Departments, provide prompt application of certain preventive and therapeutic measures which are painless, nonaggressive and highly efficient at this age. That is why primary sonoscreening of congenital hip dislocation of newborn infants in the first three days of life has been introduced at the Labor and Delivery Department of the Hospital in Senta. Methodology after Graf using a 5 Mhz linear probe is applied. Examinations are performed in the lateral position, giving a morphological finding, whereas morphodynamic data are processed after Graf classification. In clinically unstable and sonographically critical hips a dynamic hip examination is performed after Harcke. This is a teamwork of a neonatologist, ultrasonographist and child orthopedist and management of pathological hips starts at our department. Depending on indications therapeutic panties. Pavlik harness or Von Rosen band are used. Mothers are instructed how to use these appliances and take care of their newborn infants in these circumstances which helps in accepting the necessary therapeutic procedures.

RESULTS: In the period 1991-1998, 14,378 hips were examined at the Labor and Delivery Department of the Hospital in Senta. A normal sonographic finding of Ia type was found in 45.87% of hips, while Ib type was found in 18.58% of hips. There were 31.16% of sonographically immature hips of IIa plus type, whereas a pathological finding was found in 1.39% of hips. In this group of pathological hips there were 0.98% of sonographically critical hips of IIg type. 0.26% of sonographically decentered hips of IID type. 0.09% of decentered hips of IIIa type and 0.06% excentric hips of type IV after Graf. In pathologic hips, check-ups were performed every 3 weeks and every 6 weeks in sonographically immature hips.

CONCLUSION: Considering the fact that the first three months are the period of the most intensive maturation, that is the phase of absolute reduction of excentric and decentered hip in newborn infants, check-ups for infants with normal hip clinical and ultrasonographic findings were obligatory after the third month. Results of early nontraumatic and dynamic treatment proved successful on the basis of control clinical, functional, ultrasonographic and radiographic parameters. During the studied period at our territory there were no cases with aseptic necrosis of femoral head, nor necessity for surgical correction of the congenital hip dislocation.