The Problem of Instability of Reduction

The purpose of this paper is to describe a method of overcoming the instability of reduction in congenital dislocation and subluxation of the hip in children over the age of eighteen months. Despite the emphasis on early diagnosis and treatment, and although there is a great increase in the number of infants referred early, a disturbing number of children still remain undiagnosed until some time after they have learned to walk. It is with this group, over the age of eighteen months, that the present paper is concerned. Throughout this paper a distinction will be made between congenital dislocation and congenital subluxation. During the first few months of life a subluxation of the hip may either become a dislocation or remain a subluxation ; by eighteen months, however, an untreated hip that is still subluxated is likely to remain as a subluxation. In the age group under consideration the two conditions exhibit certain differences in their pathology which must be taken into consideration during treatment.