ANALYSIS OF CONGENITAL HIPS OBSERVED IN PRIVATE PRACTICE

1. Period IV was the most popular—151 cases seen during this period or 44 per cent. of the total.

2. Sex: Female 80 per cent., male 17 per cent.

3. Hips: Bilateral and left dislocations seen most frequently.

4. Age: 211, or 60 per cent. of cases, seen at 6 years or under. Four years most popular age. Operative difficulty increased and prognosis poorer after 6 years of age.

5. Symptoms: Most popular complaint, painless limp or waddle, and late walking. Objective signs, walk, Trendelenberg and shortening.

6. Difference in Length: Differences from to 1 inches seem most frequent. Anything over 1 inches greatly increases difficulty and decreases prognosis.

7. Family History of little importance; five cases of positive congenital history.

8. Birth History has little significance.

9. Opearative Result: At least 85 per cent. perfect functional results can be obtained in selective cases—within age limit and shortening not over 1 inches, preferably from to inch or less. After treatment and follow-up work is very essential. Five failures since 1915, three of which were over age limit. In our series observation on perfect hips, 1.66 years; observation on good and fair hips, 2.86 years.

10. Cast: Majority cases, 47 per cent., two casts applied: First worn 3 to 4 months, second worn 3 to 4 months; first cast, leg in 90-90 and below knee, second cast, adducted a few degrees, extended, and internally rotated, depending upon case; knee free in second cast.

11. Non-Operative Cases: Age responsible for failure to advise operation in 60 cases. In 30 cases supports were advised or applied, supports in the nature of corsets, Taylor braces, shoes, Goldthwait bands, etc.

12. Complications: Three cases of paralysis, all cleared up; one lasted a year. No fracture, circulatory disturbance, or death from shock. Eight cases with some limitation of motion.

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