[Surgical treatment of hip dislocations in children and damages caused by conservative treatment methods].

For the major requirements of the operative technique and other special problems of operation it is reasonable to discuss among the questions of the reduction of CHD the reoperations and the reconstructive surgery of hips, badly damaged by the conservative treatment, separately. We have analysed the results of 19 own cases with an average follow up of 6.3 years (3-12 years). The average age of the patients was 4.8 years. In 7 patients only conservative treatment was carried out previously, the others were also operated. The Roentgenogram revealed severe ischaemic necrosis in 10 hips. The dislocation could be reduced in every case, to the reduction however it was obligatory to add femoral osteotomy and correction of the acetabulum. The later operation was performed frequently in the second sitting. As a direct result of the operation a state, corresponding to the II. degree of Severin's radiological classification was always reached, in cases of severe ischaemic necrosis however the result later grew worse and at the follow up it corresponded only to the degrees III. and IV. (mediocre, poor). Thus the circulatory damage, suffered during the early treatment determined the late results. This was the reason that the result of the follow up examinations were better in patients in whom early surgery was performed than in patients with forced conservative treatment. The results summarized fall far behind the results of the group with primary surgery of the CHD. Without the operations described these patients would live as limping cripples, with these operations however we have improved their state significantly for the time until TEP can be performed.