EXTRA-ARTICULAR BONE-GRAFT TREATMENT FOR TUBERCULOSIS OF THE HIP JOINT

With a Special Study of the Primary Failures of Fusion

¹ The Shriners' Hospital for Crippled Children

1. The extra-articular-graft method for fixation in tuberculosis of the hip joint in children is a definite, curative, operative procedure and reduces markedly the time of treatment.

2. In the primary successful cases, the patients were able to walk unaided one and one-third years after operation, although the average duration of the disease before operation was nearly five years.

3. The longest lapse of time since operation in this series is eight years. There is every indication of permanent cure in this and the other cases of the series.

4. Successful results may be obtained even though a sinus or abscess is present at the time of operation, but a clean field is preferable.

5. Forty per cent. of the patients required more than one operation before successful result was obtained.

6. The failure of the primary operation was found in the acute cases of short duration, in which there was little destruction of the head and involvement of the acetabulum, adduction deformity, and considerable free movement in the joint at the time of the operation.

7. In those cases where a primary failure may be anticipated, it is recommended that a supplementary osteoperiosteal graft from the tibia or upper end of the femur be used in conjunction with the graft from the ilium.

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