Neonatal Hip Instability:Incidence, Diagnosis and Treatment at the University Hospital, Uppsala, 1960–1964 and 1970–1974

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Abstract
Neonatal hip instability, its incidence, diagnosis and treatment was studied retrospectively for 1960-1964 and 1970-1974. The respective populations for the 2 periods amounted to 13,065 and 16,274 children, all born at the same [Swedish] hospital. During the 1st period 191 children were referred from the maternity ward to the orthopedic department with suspected hip instability; 109 children were considered by the orthopedic consultant to have unstable hips. During the 2nd period the corresponding figures were 503 referred to the orthopedic department 189 verified as unstable. During the 1st period, 177 children were treated with Frejka pillows for about 3 mo., only 14 being left untreated. In 7 children the initial treatment was completed with a plaster cast. The results were uniformly good. During the 2nd period, 195 children were treated with a von Rosen-splint for 6 wk followed by Frejka pillows for another 6 wk (7 completed treatment with plaster); in 143 cases Frejka pillows were the sole treatment and 161 had no treatment at all. There was 1 primary plaster. The treatment resulted in normal hips in all but 1 girl. In the non-treated group 3 subluxations were verified after the neonatal period. There were 7 missed cases (diagnosed after the 1st month of life) in the first population), 15, in the 2nd. This difference is not statistically significant. The calculated incidence of dislocations if no treatment had been instituted in the neonatal period is 1.5/103 in the 1st population, and 2.5/103 in the 2nd. The difference is not statistically significant.