AN ATTEMPT TO FUSE THE HIP JOINT FOR TUBERCULOSIS

A Report of the End Result of Ten Cases

¹ The Service of the New York Orthopaedic Dispensary and Hospital

1. Results obtained in the treatment of tubercular hip joint at the present time are the most unsatisfactory of all the problems with which the orthopaedic surgeon has to deal.

2. This is true because fixation of the joint is essential to cure. It cannot be accomplished by apparatus, and no operation has been devised as yet that will assure bony arthrodesis.

3. The operations reported in this series were, with one or two exceptions, complete failures.

4. The paucity of the literature on the subject and the unsatisfactory results of the cases reported are evidence of the lack of any successful operations for obtaining complete arthrodesis of the hip.

5. In order to be successful, the operation must assure complete bony arthrodesis and must be applicable to children.

Causes of Failure. Poor vitality and low resistance of the femoral head and acetabulum in the presence of a destructive disease. The difficulty in maintaining immobility, and in children incomplete ossification. Small amount of bone contact with its tendency to organize into fibrous tissue, large amount of blood actually surrounding the bone fragments, and perhaps poor blood supply in the bone itself.

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