Reasons for late detection of hip dislocation in childhood

A retrospective study of 56 children with dislocation of the hip presenting late found that the mean age at which the parents first noticed that something was wrong (including hip abnormalities found at birth in 10 patients) was 11 months, but that at diagnosis was 26 months, a mean delay of 15 months. The reasons for delay were failure to examine the hips at birth (13 cases), failure to follow up abnormalities at birth (7), failure of symptoms noticed by the parents to alert the health-care professional to the possibility of a dislocated hip (36), failure to check the hips routinely after 3 months (27), and failure of the parents to appreciate the significance of abnormalities and to act on them (28). Hip screening should continue beyond the neonatal period and should include routine checks on all children until they are walking normally. A greater awareness in health-care professionals of the features of hip dislocation and further health education for parents are needed.