Hip deformities after successful treatment of congenital dislocation of the hip in infancy.

Much attention has been given to early detection of congenital dislocation of the hip. Early reduction, however, does not always ensure normal hip development. A retrospective study of 14 hips in 11 females treated successfully by closed methods in infancy and discharged at one year of age without further follow-up was carried out. All the patients returned between the ages of 6 and 11 years because of insidious onset of waddling gait, limping and limitation of abduction. X-rays revealed early closure of the capital femoral growth plate and progressive overriding of the greater trochanter. These changes were explained as late results of total avascular necrosis. Treatment consisted of displacement osteotomy of the greater trochanter in 11 hips for overriding trochanter, Chiari osteotomy in two for hip dysplasia, and epiphysiodesis for leg length discrepancies of 3 to 3.8 cm in four patients. The late results of early asymptomatic total avascular necrosis cannot be predicted in infancy. Long follow-up of CDH, even in cases of successful reduction in infancy, is as important as early detection and reduction of CDH,