[Ferguson's procedure in the treatment of congenital dislocation of the hip. Apropos of 42 cases].

A series of 42 hips in children aging 5 to 26 months treated initially by the Ferguson's technique is reported. The mean duration of the follow-up was 41 months. The place of this therapeutic method in the general plan of treatment of CDH was evaluated. The reduction of the femoral head was obtained in 93 p. cent of the cases, but with a lateralized position of the epiphysis postoperatively in one third of the cases. This excentration improved and the centering of the epiphysis was obtained spontaneously during the postoperative immobilization. One case of redislocation reduces the rate of success to 90.5 p. cent. An hypertrophy of the ossified nucleus of the femoral head was noted in 23 p. cent of the cases. This aspect is probably more frequent than reported when considering the bilateral cases, and must be considered as a complication of the arthrotomy. An ischemic necrosis of the femoral epiphysis complicated the operation in 5 cases (12 p. cent) causing in 4 cases an epiphyseal involvement (type 1 of Bucholz and Ogden). There has been 3 failures in obtaining the reduction peroperatively: these 3 hips have been treated subsequently by a conservative means in 2 hips and surgical reduction through an anterior approach in one hip. Two pelvic osteotomies have been necessary to treat a severe pelvic dysplasia that did not correct spontaneously. We think that this operation has a definite place among the methods of treatment of CDH. It should be indicated only in cases of failures of a conservative treatment.