Correlation of Postreduction Roentgenograms and Thirty-One-Year Follow-up in Congenital Dislocation of the Hip

Abstract

Fifty-three patients with seventy-five congenital dislocations of the hip were evaluated on the average of thirty-one years after reduction. The adequacy of reduction was determined roentgenographically by comparison with fifty normal hips from a comparable age group. The adequacy of the initial reduction was then correlated with the end-result evaluation based on pain, range of motion, and roentgenographic appearance of the hip. Only eleven of the seventy-five hips were normal with respect to freedom from pain, range of motion, and roentgenographic appearance after thirty-one years. Seven hips, perfectly reduced, were normal at follow-up. Fourteen other hips, also reduced to a theoretically normal position, were not normal by these criteria. Only four hips, outside the range of a theoretically normal reduction, were normal thirty-one years later. It can be concluded that a perfect reduction must be achieved if one is to expect the long-range result to be a normal hip. However, all perfect reductions were not followed by the development of perfect hips. This finding indicates that a perfect reduction is a significant factor, but certainly not the only one. Prevention of the vascular complications of reduction and perfection in the initial reduction emerge as the factors which in this series would have improved results.