CRITICAL EVALUATION OF THE SHELF OPERATION OF THE HIP JOINT

Abstract

Recently in Japan, it has become a common practice for children to have health consultation during infancy, and this practice is being carried out quite extensively. It cannot be denied that this practice has not only contributed to the early detection of congenital dislocation of the hip joint, but has greatly improved the results of treatment. However, taking the hereditary and fatal deficiency of development in congenital dislocation into consideration, results are far from ideal.At the Department of Orthopedic Surgery, Kurume University Hospital, the scheme as reported by Seddon in 1951 is still followed, but many problems remain to be solved, such as the changes of the femoral head and neck, residual subluxation, hypoplasia of the acetabular roof and secondary osteoarthritis. Particularly, after the age of puberty, hypoplasia of the acetabular roof is considered to be the most important factor causing secondary coxarthrosis which interferes with the function of the hip joint. Hitherto, various interpretations and methods have been introduced concerning the treatment of hypoplasia of the acetabular roof. However, results have not always been satisfactory. Recently, Chiari's pelvic osteotomy has been widely adopted in Japan for this type of operation. The authors have critically reviewed the results of the shelf operation performed at this department.