• K T Cunningham, A Moulton, S A Beningfield, and C R Maddock.
• Lancet. 1984 Mar 24;1(8378):668-70.

Abstract7864 infants were examined within 48 h of birth by junior medical staff; 5 with dislocation, 16 with dislocatable hip, and 25 with joint laxity were referred for abduction splinting. 622 of the infants (7.9%) had minor signs (clicking or grating hip). When these 622 infants underwent clinical and radiological examination at 4 months of age, 34 had serious hip pathology (5 dislocation, 5 dislocatable hip, and 24 radiological abnormalities). Of the 7196 infants considered normal in the newborn period, 7 were referred for orthopaedic opinion (3 with dislocation and 4 with subluxation) at age 2-9 months by general practitioners and community health physicians. Thus, dislocated or dislocatable hips were 39 times more frequent in infants who had minor signs on examination within 48 h of birth than in infants considered normal. The implication of these findings is that clicking and grating of the hip are important signs which require systematic follow-up, with radiological examination at 4-6 months.

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