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Journal of Bone and Joint Surgery, 1951;33:171-190.
© 1951 by The Journal of Bone and Joint Surgery, Inc

CONGENITAL DISLOCATION OF THE HIP

Part II. Results of Open Reduction as Seen in Early Adult Period

WILLIAM K. MASSIE M.D.1 and M. BECKETT HOWORTH M.D.1

1 New York Orthopaedic Hospital, New York City

1. The results eighteen years after open reduction of the fitty-eight hips are as follows:

[see pdf for table]

2. The optimum roentgenographic grade was attained two years after reduction in 66 per cent. of the hips, and by puberty in 85 per cent. Hips followed roentgenographically in children between the ages of five and eight years show definite trends toward the eventual adult result, a fact which is of practical value in determining further treatment.

3. Vascular changes were seen in 41 per cent. of the femoral heads In 81 per cent. of the hips so involved, the roentgenographic rating was below 70 per cent. of normal

4. It is again proposed that an initial capsular relaxation is the primary abnormality in congenital dislocation of the hip. Subluxation and dislocation are the result of the mechanical forces applied to the hip with a relaxed capsule. The acetabular changes are secondary.

5. Any degree of post-reduction subluxation seriously jeopardizes the development of a normal adult hip. Increase of the subluxation ensures an unsatisfactory result. On the other hand, the obtaining and maintaining of perfect reduction ensure an excellent result if no vascular change affects the epiphysis.


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