[Experience with 3-stage screening for detection of congenital hip dysplasia].

We report an experience with a three-stage screening programme which has recently been recommended. It comprises the examination of children at three successive periods - at birth, at six weeks and at three months. In a prospective study we evaluated 789 children at all three periods. Pathological (unstable) hips were found at birth in about 20 per cent, the majority being lax hips and all underwent immediate treatment. At six weeks we were unable to detect any sign attributable to hip dysplasia except one instability persisting from birth. A limitation of abduction in one or another hip at six weeks or at three months was present in about 6 per cent; it was explained to be related rather to one of the signs of the moulded baby syndrome than to hip dysplasia. We do not regard the second examination in a three-stage screening programme as obsolete though it did not provide us in this series with additional informations; but our experience shows that three weeks would do better than six weeks, and the examination should be focused mainly on hip instability. We feel, however, that the greatest majority of pathological hips if not all should be detected at the maternity ward by a competent examiner.