Congenital Dislocation of the Hip

A large number of congenital dislocation of the hip remains undiagnosed before a child begins to walk, unless screening tests are performed on newborns and infants. It is well-known that congenital dislocation of the hip can result in marked acetabluar dysplasia, in deformity of the femoral head and in a change of the femoral-neck angle: conversely, a normal hip joint can be expected when the femoral head is replaced in time in the acetabular socket. The authors studied 33 cases of 37 congenital dislocations of the hip treated with closed reduction and immobilization in a changing cast after adequate premanipulative skeletal traction at the orthopedic department of the Presbyterian Hospital, Taegu. As result of this study, the following conclusions were reached: 1. The preponderance of girls to boys was found to be 3.7 : 1. 2. The ratio of unilateral to bilateral cases was 29 : 4 and of right to left was 12 : 17. All 4 bilateral cases were female. 3. An associated congenital anomaly was observed in a case of thyroglossal duct cyst. There were 2 cases of breech presentation. 4. Instead of a soft tissue releasing operation, in most cases we applied adequate skeletal traction(plus one to two station) in the distal femur for 2 to 3 week before reduction. That was the same as a series of traction stations referred to by Gage and Winter(1972) which relates the position of the femoral head to the acetabulum by traction. 5. The average time of following up was 24 months. 6. There were 2 cases of epiphyseal change. One of the cases did not appear as a proximal femoral epiphysis until the 8th month of postreduction and the other was a fragmentation of the femoral epiphysis without signs of increased density after reduction. These 2 cases resulted from inadequate traction. We will follow up these cases for an adequate time. 7. There were several cases of unsatisfactory results functionally and anatomically, in acetabulum and head relationship and the femoral-neck angle. 8. The duration which required for joint stability clinically was shortened in cases of early treatment. 9. The average time of cast immobilization was 7 months.