NEONATAL SCREENING OF CONGENITAL HIP DISL OCATION - COMPARATIVE-STUDYIN BRETON AND MEDITERRANEAN POPULATIONS

Background. - Congenital dislocation of the hip varies greatly in inci dence among different regions. This work is aimed at comparing results of clinical investigation and ultrasonography of the hip in Languedoc -Roussillon and Brittany. Population and methods. - Two thousand eight hundred and twelve and 2809 neonates admitted to Nimes and Vannes hos pitals respectively, were enroled in a prospective study. Clinical exa minations were made according to the protocol established by the ''Gro upe d'etudes an orthopedie pediatrique''. Ultrasound investigations we re performed in every risk case. Results. - No dislocation occurred in the 4946 neonates without risk factors. In the 675 neonates with risk factors, 213 ultrasonographic examinations were abnormal, more freque ntly in the Brittany group (P < 0.001); nine dislocations were observe d. A familial history of hip dysplasia (P < 0.001) and the addition of two risk factors (P < 0.001) were more frequent in Brittany. One hund red and six cases required treatment, more frequently in Brittany (P < 0.001). Conclusions. - Some clinical risk factors and delayed ossific ation or hip dysplasia at ultrasound examination are significantly mor e frequent in Brittany. Clinical examination with selective ultrasonog raphy is a reliable method, allowing early diagnosis and treatment of delayed dislocations.