Management of old unreduced traumatic dislocations of the hip. A study of twenty nine cases

Abstract

Twenty nine cases of neglected traumatic dislocations of the hip seen after an interval of 14 days to 6 years from the date of injury have been studied over a period of 5 years. There were 18 children and 11 adults. The cases were treated by closed reduction, open reduction, corrective trochanteric osteotomy and resection of the head and neck of the femur. Minimum follow up was 3 months and maximum 12 months, average 5.1 months. An initial period of traction followed by manipulation under general anaesthesia succeeded in achieving reduction in 4 cases. Operative reduction was performed after a period of traction in 21 cases. The results were comparatively better in adults, 85.7 percent showed excellent results in contrast to 57.1 percent excellent or good results amongst children. In the limited follow up only one case showed flattening of the capital epiphysis. Anterior approach to the hip was found useful as it permitted mobilisation of the contracted soft tissues in the anterior aspect of the joint.