ULTRASONOGRAPHIC EVALUATION OF BREECH PRESENTATION AS A RISK FACTOR FOR HIP-DYSPLASIA

In order to gain more information of breech position as a risk factor for congenital hip dysplasia or dislocation, the hips of 408 newborns delivered in the breech position were examined by ultrasound. Clinical examination was performed by both experienced paediatricians and orth opaedic surgeons. The infants were re-examined by ultrasound at 2-3 mo nths of age. Twenty-five newborns (6.1%) had neonatal hip instability. Breech presentation as a risk factor was confirmed, with first borns, breech position with extended knees, and high birthweight as special high-risk groups. Ultrasound showed subluxation in most of the unstabl e hips. The main benefit of using ultrasound was that direct visualiza tion permitted more reliable evaluation, especially when the clinical findings were uncertain. Normal ultrasound findings in false positive and uncertain Ortolani tests reduced the frequency of unnecessary trea tment. Because ultrasound was used in follow-up, the need of radiograp hy was reduced. There were no late-detected cases of hip dysplasia or dislocation, indicating that routine follow-up is not necessary in bre ech infants with normal hips at birth, provided that the neonatal scre ening is optimal.