Congenital dislocation of the hip. Observations on the early diagnosis and results of treatment with an abduction brace in infants two to nine months of age in Greece.

In Greece, despite efforts toward early diagnosis of congenital dislocation of the hip (CDH) during the last 20 years, treatment of 75% of infants so diagnosed has not been begun until they are 2 to 9 months of age, with an average treatment onset age of 4.6 months. Five hundred eighty-seven infants (947 hips) two to nine months of age with typical CDH or subluxation were treated with a specially designed abduction brace. This brace, which has been in use for more than 22 years, proved simple and reliable. The follow-up period ranged from two to 20 years (average, 4.5 years). Excellent results were found in 862 hips (91.0%), good results in 44 hips (4.5%), fair results in 32 hips (3.5%), and poor results in nine hips (1.0%). Changes due to ischemic necrosis were noted in 6.8% of the hips, with severe changes present in 3.0%. The most recent results have improved as a result of greater attention to very gentle and gradual abduction of the hips before the application of the brace and the avoidance of extreme abduction positioning in the brace.