ACETABULAR DEVELOPMENT AFTER REDUCTION OF CONGENITAL DISLOCATION OF THE HIP: A FOLLOW-UP STUDY OF FIFTY HIPS.
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The paper presents a series of 51 hips (5 boys, 33 girls) that underwent reconstructive surgery because of congenital hip dislocation. Surgical treatment involved a one-stage procedure, consisting of correction of the proximal femur position and acetabuloplasty. Acetabulum reconstruction was achieved by using one of three methods: Pemberton osteotomy, Salter osteotomy and a "shelf-type" acetabuloplasty. Excellent and good results were found in 84% of the cases under 4 years of age, irrespective of the acetabuloplasty implemented.
Four cases of traumatic dislocation of the hip joint with fracture of the shaft of femur on the same side, and one case of bilateral hip joint dislocation with a fracture of shaft of femur on one side are reported. Pitfalls in diagnosis and hazards of delayed treatment are emphasized. Methods of treatment are outlined. Complications such as avascular necrosis of the head of the femur and sciatic nerve palsy are discussed. Avascular necrosis of the head of the femur is not inevitable even after reduction of the joint has been delayed for several days.