Interstate medical journal . othe other leg. In a case of double congenital dislocation, the legs are near thesame length, the gluteal folds are symmetrical. The trochantersare both high, high above Nelatons line. They both slip up anddown as the weight is shifted from one leg to the other. The backis lordosed; the abdomen protrudes. The hips are prominent. Thewalk is characterized by a waddle. Congenital hip may be confusedwith coxa vara, fracture of the femur, tuberculous hip, traumaticdislocation, infantile paralysis, etc., but is usually easily differen-tiated by the history of the case. 7
Interstate medical journal . othe other leg. In a case of double congenital dislocation, the legs are near thesame length, the gluteal folds are symmetrical. The trochantersare both high, high above Nelatons line. They both slip up anddown as the weight is shifted from one leg to the other. The backis lordosed; the abdomen protrudes. The hips are prominent. Thewalk is characterized by a waddle. Congenital hip may be confusedwith coxa vara, fracture of the femur, tuberculous hip, traumaticdislocation, infantile paralysis, etc., but is usually easily differen-tiated by the history of the case. 730 INTERSTATE MEDICAL JOURNAL Treatment. Now, there is no chance for these patients unless,after recognition of the condition, the parents can be made to seethe necessity for this operation and for a six or eight months con-finement in a plaster cast. It is surprising how often this deformityin the young child causes such slight tendency toward a limp thatthe condition is minimized by the parents, who insist that the trouble. Fig. 3.—Back view of patient shown in Fig. 4.—Front view of patient shown in Figs. 1 and 2 five years later, at 11 Fig. 3. A girl who looks fit to meet years of age. Reduction accom- all physical demands of life. The plished by manipulation. Perfect hips are strong and contour normal,function. See Fig. 6. will be outgrown and who neglect treatment until the increasingweight and function finally convince them, when too late, that treat-ment is called for. Here, then, is the second link of so vital im-portance in this series of four steps in the cure of congenital efforts of the field nurse or social worker in having an examina-tion made to determine the reason why a child has walked late orlimps is of vital importance, but it amounts to little, unless the final Thomas: Congenital Dislocation of the Hip 731
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