The late results of early treatment of congenital dislocation of the hip in the von Rosen splint have been recorded in a follow-up study of 111 children with an average age of ten years (range eight to sixteen). The clinical diagnosis had been made within two days of birth and in most cases confirmed by radiological examination. Splintage was in all cases begun within the first few days and maintained for an average period of ten weeks. Two cases of failure of the initial treatment were encountered but had good final results. The follow-up study included a radiological examination in which were recorded the general configuration of the joint, the CE-angle described by Wiberg, the presence or absence of an os acetabuli and the roundness of the femoral head. The findings were compared with those in a control group of 222 normal children. All the treated hips developed normally except for a single case of minor dysplasia and a single case of slight enlargement of the femoral head and neck following appearances suggestive of avascular necrosis at the age of two years.
Cox. 1910.Books nowadays often contain descriptions of so many different surgical methods that a reader more or less unacquainted with the subject finds it quite impossible to determine which is the best plan to adopt in the particular case under observation.In this book the case is not so ; the lines laid down by Lorenz are acknowledged and strictly followed. Added to this we have
The hip joint space in standard anteroposterior images of 120 normal subjects was measured with the aid of a special transparent pattern. The normal value was slightly over 4mm, scattered between 3 and 5 mm, except for elderly men in whom values of 6 mm or more may be normal. The lower borderline value does not change with age, nor is there any change in the average joint space with age except in men in whom it increases slightly. A narrow joint space in an elderly patient should not be expected simply because the patient is old. The measuring technique is useful in population studies. In individual cases a simple measurement with a ruler serves the same purpose if the outline of the acetabular roof is well-defined on the images.
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