OPERATIVE FIXATION OF TUBERCULOUS HIPS IN CHILDREN

End-Result Study of Thirty-three Patients from the Orthopaedic Department of the Childrens' Hospital

This report must be considered in the light of a preliminary study. The number of patients observed is not sufficiently great to warrant positive statements relative to the healing of bone and joint tuberculosis. An additional ten to fifteen years of observation will be essential before it can be definitely recommended that all tuberculous hips in children should be fused in a position of fifteen degrees of flexion and ten degrees of abduction.

It is believed that early fusion of tuberculous joints conserves the growing elements of bone, thereby eliminating the disability due to shortening.

Hibbs's observation, that fusion of the bone flap or strut is followed by consolidation of the diseased area, has been confirmed.

Joint tuberculosis will heal rapidly when motion is eliminated. This may be successfully accomplished by iliofemoroplasty. Draining sinuses are not a contra-indication to iliofemoroplasty. The sinuses will close when the bone and joint lesion is healed. Secondary infection is of no practical importance so far as the operation itself is concerned. The general physical condition of the patient is uniformly good after ankylosis of the diseased joint takes place.

Iliofemoroplasty is not a difficult technical procedure and it may be done without danger to life.

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