The Journal of Bone and Joint Surgery, Vol 77, Issue 7 975-984, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Congenital dislocation of the hip in boys
JL Borges, SJ Kumar and JT Guille
Alfred I. duPont Institute, Wilmington, Delaware 19899, USA.
Fifty-five boys with seventy-eight congenitally dislocated hips were
treated between 1965 and 1990. The patients were divided into three groups
according to the initial treatment. Group I included thirty hips
(twenty-two boys) that had been treated initially with a Pavlik harness.
Two hips (7 per cent) had a successful outcome, and twenty-eight (93 per
cent) needed additional methods of treatment. Group II included forty-two
hips (twenty-nine boys) that had been treated initially with closed
reduction and immobilization in a hip-spica cast. After the closed
reduction, twenty-nine hips (69 per cent) were considered stable, although
fifteen (52 per cent) of them needed a secondary procedure because of
residual subluxation or persistent acetabular dysplasia. Thirteen hips (31
per cent) were considered unstable after the closed reduction and
subsequently had an open reduction. Group III included six hips (four boys)
that had been treated initially with open reduction. Two of these hips
redislocated after the open reduction, and they were reduced with an
additional open reduction. A pelvic osteotomy was later performed to treat
persistent acetabular dysplasia in these two hips. Two hips that had been
treated with an open reduction and concomitant pelvic and femoral
procedures did not need additional treatment. This study demonstrates that
boys who have congenital dislocation of the hip do not always respond well
to treatment and constitute a high-risk group.
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