Abstract
Eighty-three joints in 50 patients with congenital dislocation of the hip were followed up for 5 to 15 years after closed reductions, The reductions were performed after Lorenz's method under ether anesthesia, The age of patients was between 5 months to 3 years, Among the 83 joints in 50 cases reported, 47 joints were redacted in less than 1 year of age and the remaining 36 were elder than 1 year of age, Results of the closed reductions were evaluated with the subjective, objective findings and X-ray examinations.
1) uses undergone reduction in less than 1 year of age showed better results than those over 1 year of age.
2) Results on clinical evaluation were excellent in 59ao of the cases, good in 27. 7%, fair in 9.6%, poor in 3.6%, but on X-ray evaluation excellent in 30.1%, good in 48.2%, fair in 20.5%, poor in 1.2%.
3) These results were not only related to the age of patients but also to the degree of dislocation, the shape of acetabular roof, the technic of reduction and the postoperative treatment.
4) There were some cases which showed clinically good and unsatisfactory on X-ray examinations. X-ray changes did not overcome clinical manifestations, particularly in those cases in which the clinical symptoms began to appear in hip joint. The cases with subluxa tion of the hip at the time of treatment revealed unexpectedly discouraging results with poor congruence and other anatomical changes of the joints at the time of survey.
5) The results of the therapy were not parallel to the degree of dislocation.
The survey revealed generally poor results in cases of the coxa vara, excessive antetorsion, aseptic necrosis and non eccentricity of the femoral head which developed after completing routine treatment.
6) These studies suggest that early diagnosis and early protective reduction are necessary in congenital dislocation of the hip.
In our hospital every new born infant used to be checked within 1 week after birth at orthopedic department, having a close contact with gynecologists and pediatricians.
Especially for the hip joint, Ortolani's Click test and Barlow's technic are performed as routine procedure. When a dislocation is suspected, then the baby is examined by the both methods of Andren and von Rosen.
522 babies had been checked, 15 showed subluxation or dislocation, and underwent early treatments.
Recently, von Rosen's splint has been used and in the cases which failed to be reduced naturally by this splint, the apparatus applied with universal joint is used with good result after over-head traction.
