[Late results of conservative treatment of congenital dislocation of the hip--over twenty-five years follow-up observation and statistical analysis of roentgenograms (author's transl)].
The present study was based on the findings of 87 cases of CDH (132 joints) published by Prof. Igari and his colleagues in 1960. All these patients had been treated with conservative methods between 1935 and 1952. The average age at the time of the first follow-up examination was 11 years. Fortunately in 1978, after an average follow-up of 29 years (range 25 to 39 years), the author was able to reexamine 59 (90 joints) of the original 87 cases. The average age of the patients reexamined in 1978 was 31 years. In addition, 18 cases (26 joints) of CDH which were not treated and reached the age over 18 years were studied for comparison. The following observations were made: 1) Of the 90 joints examined, 18 joints (20.0%) showed normal findings in the roentgenograms. Twenty (39.9%) of the 59 cases were healed from a clinical standpoint. 2) The measurements which were taken at school age (1960), especially acetabular angle, approximate-acetabular-quotient, C.E. angle and acetabulum-head-quotient had a statistical correlation with those of the present reexamination. 3) Joints with a well-developed acetabulum at school age, even those with slight deformities of the femoral head and neck, were found to have become congruous by middle age. 4) The femoral head growth in untreated dislocated joints was poorer than the femoral head growth in joints which received conservative methods. The following conclusions were made: 1) The results of the reexamination were poorer in patients above 30 years of age than in patients under 29 years of age. However, it cannot be said without reserve that the results become poorer with an increase in patients' ages. The progrnosis is dependent on the time when treatment was started and the degree of displacement. 2) In patients who were treated on late stage the acetabulum seems to have developed poorly. The severity of the deformity of the femoral head and neck is related to the degree of displacement. 3) The disturbance of the femoral head nucleus during the treatment period gives some influences on the growth of acetabulum and femoral concentration, making its prognosis poorer. 4) The acetabular angle and C.E. angle at the end of treatment had a prognostic value. Joints with an acute acetabular angle (above 31 degrees) at the end of treatment should be treated with surgical methods.
D000328:Adult; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000628:therapy*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011859:Radiography; D013223:Statistics as Topic; D013997:Time Factors