[Results of early surgical reduction of congenital hip dislocation].

Abstract

Authors report on the results of 118 early operative reductions, performed with their own method in the treatment of the congenital dislocation of the hip. Postoperative functional treatment with Pavlik's harness or abduction splint belongs to their method. Secondary operations were performed in 21 per cent: derotation femoral osteotomy and Pemberton's operation. The younger the patient was at the reduction the rarer was secondary operation necessary. The age of the patients was 6-24 months at the operation (in average 13 months) The follow-up time was 2-12 years (in average 6.1 years). The results corresponded radiologically to Severin's I + II grades (excellent and good) in 98 per cent. Clinically 98 per cent were excellent, 2 per cent fair. The good results are first of all attributed to their postoperative treatment: 1. They avoided the stiff plaster bandage and so no tension of the soft parts could develop, that would endanger the blood supply. In consequence ischaemic damage, belonging to Kalamchi's and Mac Ewen's group I was found only in a few cases. No damage belonging to the severe forms II-IV was observed 2. Their treatment: secures the central reduction and allows spontaneous joint movements in functional position: factors meaning the maximal stimulus of joint development. The condition of this postoperative treatment is the stability of reduction, secured by their special plasty of the capsule.