Neonatal screening for hip joint instability. Its clinical and economic relevance.

Effort to determine the efficacy of neonatal hip examination began in 1967. During the subsequent 23 years, there have been three analyses of the study's data: (1) a retrospective review reported in 1981, (2) a prospective examination in 1989, and (3) an economic evaluation in 1990. The retrospective review concluded that a neonatal hip screening program effectively screens for acetabular dysplasia, and early treatment seems to alter the outcome of congenital dislocation of the hip. The prospective examination, involving 62 newborns diagnosed as having dislocated or dislocatable hips, established that such cases can be effectively treated from birth with flexion/abduction splints monitored by routine clinical and follow-up examinations. An economic evaluation of the data demonstrated an economic benefit of more than $15,000 Cdn per 1000 infants screened. This study, through these three analyses, presents a compelling argument in favor of a routine, standardized neonatal hip examination.