Clinical and Radiological Results of Congenital Hip Dislocation in Breech Presentation.

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This study was performed to investigate differences in treatment of congenital hip dislocation between breech and cephalic presentations.30 dislocated hips from breech presentations and 75 dislocated hips from cephalic cases were radiologically and clinically assessed.Smooth reduction by Pavlik Harness was achieved in 20 of 30 hips in breech cases (67%), and in 60 of 75 hips in cephalic cases (80%). There was no statistical difference in reduction ratios.Avascular necrosis was observed in 19% of breech cases and in 11% of cephalic cases but these differences were not statistically significant.Fifteen hips from breech cases and 26 hips from cephalic cases were followed over 6 years. Anatomical healing (Group I of Severin's classification) assessed by X-ray was 60% of breech cases and 88% of cephalic cases. Cephalic cases showed better prognosis on X-ray than breech cases.Distance a and b, as defined by Yamamuro, and acetabular angle did not show any remarkable differences between breech and cephalic cases. In conclusion there were no differences in difficulties of treatment in congenital hip dislocation between breech and cephalic cases.
西日本整形・災害外科学会の論文