Conservative treatment of congenital dislocation of the hip in infants 1 to 9 months of age

Abstract

The results of conservative treatment of congenital dislocation of the hip (C.D.H.) in 630 neonates and infants aged 1 to 9 months with 1005 typical dislocations or subluxations are discussed. The 630 cases were divided into two groups. In group I, 120 neonates and infants aged 1 week to 2 months (195 hips) were treated by various methods of hip abduction (Von Rosen splint, clothes, pillows, plastic splints). The follow-up ranged from 1 to 13 years (mean 1.4 years). The results were excellent in 94.5%, good in 4%, fair in 1%, and poor in 0.5%. All 510 infants (810 hips) of Group II were treated with a specially designed abduction brace. The brace was applied only for reducible dislocations that were stable in the safe zone of abduction. A satisfactory range of abduction was obtained prior to the application of the brace. The results of treatment with the brace in 810 hips were excellent in 91%, good in 4.5%, fair in 3.5% and poor in 1%. Ischemic necrosis of the proximal femoral epiphysis occurred in 6% of the hips in Group I, and was significant enough to cause deformity in 2.55%, and in 7% of the hips of Group II, with significant changes in 2.7%. The brace has been used for 22 years and found practical and reliable. The results of treatment compare favorably with other series in the literature.