SURGICAL TREATMENT OF THE RESIDUAL DEFORMITY FROM SUPPURATIVE ARTHRITIS OF THE HIP OCCURRING IN YOUNG CHILDREN

¹ Division of Orthopaedic Surgery, The Department of Surgery, The University of Chicago

Suppurative arthritis of the hip in the very young child usually runs a benign acute course, but results in destruction of the entire cartilaginous portion of the upper femur. When the child begins to walk, the pathological dislocation so produced is evident.

The presence of the pathological dislocation cannot always be decided from a study of roentgenograms. Physical examination and comparative roentgenographic study of the pelvis, when reverse traction is applied to the abnormal leg, may demonstrate a hip stabilized by sufficient cartilage.

When the presence of a pathological dislocation is demonstrated, good results may be obtained by the type of reconstruction operation described in this report. The optimum time for this operation is during the second and third years of life. Roentgenograms taken prior to operation will demonstrate any internal markings in the bone which might contra-indicate the reconstructive operation.

While only two reconstruction operations upon children so young have been reported (Hallock's case and the one presented here), the amount of articular bone produced, and the subsequent stability of the hip favor the early recognition of these rare cases, and their immediate treatment by reconstruction. The patients should then be followed closely and appropriate measures should be taken to equalize leg length as indicated.

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