EARLY WEIGHT-BEARING AND THE CORRECTION OF ANTEVERSION IN THE TREATMENT OF CONGENITAL DISLOCATION OF THE HIP

¹ Shriners' Hospital for Crippled Children, Portland

1. From this study it appears that we have not used skeletal traction and derotation osteotomies frequently enough, although their use has become more frequent as this routine of treatment has been developed.

2. There is no correlation between the acetabular index and good and poor results.

3. Uncorrected abnormal anteversion does affect the results adversely.

4. Correction of anteversion by osteotomy decreases the necessity for open reduction.

5. Anteversion should be corrected before a turndown shelf operation or intraarticular procedures are done.

6. No specific degree of anteversion can be accepted as a definite indication for derotation osteotomy in all ages. The younger the child, the more likely it is that the "natural growth processes" will correct the anteversion. Any doubt should be resolved in favor of doing the osteotomy. In the author's opinion 30 degrees of anteversion is an indication for doing a derotation osteotomy.

7. It is the author's belief that the subtrochanteric area is the proper site for the derotation osteotomy.

8. The walking cast used after reduction does not appear to increase the incidence of aseptic necrosis of the femoral head.

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