The hamstring stretch sign. a reliable clinical test for the detection of congenital dislocation and dysplasia of the hip

Abstract EN

Objective : Introducing a reliable clinical test for detection of €ongenital Dislocation and Dysplasia of the Hip (CDH).

Design : Clinical examination of cases suspected of having Congenital Dislocation of the Hip was performed by a senior and junior staff member in the clinic.

Setting: The clinical tests used were the Ortolani-Barlow test, limitation of hip abduction in flexion, and the Hamstring stretch sign.

Subjects : All patients referred to the Pediatric Orthopedic Clinic at King Khalid University Hospital suspected of having CDH during a one year period.

Main Outcome and Measures: Results of the tests were analysed with regards to sensitivity, specificity and predictive value, after confirming or excluding the presence of CDH using Ultrasound for new born or x-rays for older children.

Results: One hundred and eighty hips in 90 patients were examined.

In 64 hips (below 6 months of age) the sensitivity of the new sign was ?٥% compared to 64% for the Ortolan؛- Barlow test.

In 116 hips (above 6 months of age) the sensitivity of the new sign was 98% compared to 88 % for limitation of hips abduction in flexion.

The overall sensitivity of the new sign (test) was 86 % in hands of junior staff and 89 % in the hands of senior staff.

Interpretation : The new sign is as good as Ortolani-Barlow sign in detecting CDH below the age of 6 months and as good as the limitation of hip abduction in flexion for those above 6 months of age.

Conclusion : The Hamstring stretch sign is a good supplementary test in the screening for CDH in children.

Bahrain Med Bull 1999 ; 21(4) : 118 - 21.

Congenital dislocation and dysplasia of the hip is a in order to decrease the number of missed cases.

These common problem encountered in medical practice in range from the performance of special clinical bed side Sandi Arabia, ?ediatricians usually screen all newborns examination of neonates, screening or for this problem, yet many cases present late after the x-ray for suspected cases and those at risk^^.

No matter child starts walking with limping*'^.

Different how good a test is, the human factor plays a major role diagnostic modalities have been suggested and practiced in detecting or missing cases.