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  • Title: [Comparison of the therapeutic results at the end of growth of dislocation of the hips diagnosed at the time of walking and treated by slow reduction and correction of the axis of the femoral neck with or without arthrotomy (open reduction)].
    Author: Laumonier F, Mallet J, Coupris L.
    Journal: Chir Pediatr; 1984; 25(2):65-73. PubMed ID: 6744502.
    Abstract:
    The study concerns the results at the end of growth of an homogeneous series of congenital dislocation hips, treated by slow reduction, and secondary femoral neck osteotomy. Some of these hips were initially treated orthopaedically, others were operated for open reduction, more often, on account of a principle of treatment than due to necessity. The comparison of these two series allows the conclusion that the nocivity of the surgical procedure was demonstrated in most cases. The study demonstrated some harmful actions in the treatment of congenital dislocation hip at the age of walking. According to the authors, they aggravate the rate of deformities due to vascular lesions. The authors stress some therapeutic necessities, and describe their present attitude towards these hip dislocations. Their attitude is based upon a mild reduction, under progressive traction, abduction, and medial rotation. Tenotomies are, if necessary, performed previously. A plaster immobilization is then applied, until a sufficient penetration of the femoral head into covering acetabulum. In most cases, an abnormal femoral neck orientation was corrected by an osteotomy. An innominate osteotomy to improve the cover of the head was only performed when the centering of the head remained imperfect. By modifying an already ancient technique, which was proved by 84% good results in a series of 112 hips reviewed at the end of growth, the authors expect an actual decrease of the late trophic deformities.
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