Early Diagnosis and Treatment of Congenital Dislocation of the Hip Joint

Abstract

SUMMARY Since 1952 clicks (ad mod. Ortolani) have been observed in 14 hip joints out of eight newborn girl children. In all cases the X-ray investigation revealed a dislocation upward and/or laterally of the upper end of the femur. Treatment was commenced immediately. Six children were given ambulatory treatment by keeping the legs in the abduction position by means of a cushion or plate. It was necessary to admit two children to the orthopedic clinic for a period of plaster treatment. The follow-up examination shows roentgenologically nor- mal or almost normal hip joints with the exception of one joint which reveals a slight subluxation. The cases reported show that it is of great—perhaps decisive—importance that the treatment should be started immediately after birth. An aluminium splint is described which is used for two children treated very recently. In the city of Malmö (approx. 200,000 inhabitants) since 1952 almost all newborn infants have been examined by pediatricians for Ortolani click amongst other things. By this means all the new cases of hip joint luxation seem to have been discovered. Early diagnosis and early treatment presuppose cooperation between pediatricians in the maternity department, radiologists and orthopedic surgeons. Achieving this is a problem of organisation. The treatment should be guided and supervised by the orthopedic surgeon since he has the best qualifications for judging the development of the condition during the course of the treatment.