THE RESULTS OF TREATMENT OF CONGENITAL DISLOCATION OF THE HIP IN INFANCY

¹ Shriners' Hospital for Crippled Children, San Francisco Unit, The Hospital for Women and Children, and The Franklin Hospital, San Francisco; and the Division of Surgery, Department of Orthopaedic Surgery, University of California Medical School

1. The standards of Severin and Ponseti have been used in an evaluation of the anatomical and functional results of treatment in 112 cases of dysplasia and dislocation of the hip.

2. Excellent or nearly excellent anatomical results were obtained in 55.4 per cent.; and 60.7 per cent. of the functional results were excellent. Deterioration with age would not be expected in this group. The best results were noted when the treatment used was the least traumatic.

3. Good anatomical results were produced by treatment in infancy in 81.3 per cent., and good functional results in 80.4 per cent., of the hips examined. The temporary nature of these results is not disputed, since all of the patients were less than fourteen years of age when the ratings were made.

4. The development of the acetabulum progressed slowly, indicating a probable need for longer periods of fixation after reduction of the hip. Delay in reduction of dislocations causes increasing maldevelopment of the hip, due in part to a thickening of the acetabular floor coincident with an increase in the Y coordinate. These factors are of importance in treatment and prognosis.

5. There is a direct relation between the early institution of treatment and the good results reported.

6. Even with an early diagnosis and an early application of treatment, the results of the treatment of congenital dislocation of the hip in infancy are far from perfect. Great effort must, therefore, be directed toward both earlier recognition of the dislocation and improvement of the present methods of treatment.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?