Reduction of Neglected Congenital Dislocation of the Hip in Children over the Age of Six Years

Thirty-two neglected congenital dislocations ofthe hip in twenty-two children over the age ofsix years were treated by traction, open reduction and Chiari osteotomy. In five hips, where prolonged traction failed to bring the femoral heads into the vicinity of the acetabulum, a shortening subtrochanteric osteotomy of the femur was performed. The overall results were good and this regime of treatment is recommended. The best approach to congenitally dislocated hips is early detection and treatment. Unfortunately, in less favoured populations the dislocation is usually only discovered when the child starts to walk. Even then, orthopaedic treatment is sometimes unavailable and has to be delayed until thc family migrates or a new surgical team arrives. Such were the circumstances here, for our hospital serves a large population of immigrants and a neighbouring area where orthopaedic treatment was unavailable until 1966. Since then, an increasin