[Early diagnosis of congenital hip dislocation in neonates].

On the basis of the analysis of the examination of hip joints in 1000 newborns the author supports his former statement that of almost the same frequency as the acknowledged symptomatology of unstable hip joint (in 6.5 per cent) is the pathological symptomatic group of increased tension of tendons of the origin of adductors (in 4.7 per cent), sometimes also with reduced abduction, less palpable head of the hip joint and the symptoms presented by him can improve the quality of screen position case of breech presentation. This was found in 5.2 per cent of deliveries. The combination of both symptomatic groups occurs in 1.4 per cent. Out of individual symptoms in the breech presentation of highest frequency--according to the author--is the increased tension of the origin of adductors (in 94.2 per cent), be it isolated form of incidence (in 25 per cent) or in combination with other symptoms. In the examination technique he includes also the symptom of the hyperextensibility of the knee and relates its frequency (82.7 per cent) with the breech presentation and with the increased joint laxicity conditioned hormonally. After the analysis of mechanical effects in the foetal stage of pregnancy he attempts to correlate clinical neonatal symptomatology with the pathological anatomical classification after Ogden. He arrives at the conclusion that only combined identification of symptoms of both the instability of the hip joint and the symptoms presented by him can improve the quality of screening and thus reduce the incidence of unidentified defect of the hip joint in 3rd month of age of the child. Further progress can be made only after the introduction of a purposeful sonographic screening of the newborn and infant hip joints. The author, however, considers for irreplaceable the method of a careful clinical examination of newborns.