The treatment of unreduced congenital dislocation of the hip in adults.

In their review of the late results of the treatment of congenital dislocation of the hip Muller and Seddon (1953) commented that between the ages of twenty-three and thirty-three years nearly half the previously satisfactory joints become troublesome in one way or another. When reduction of the dislocation has been achieved, the problem usually becomes one of treatment of a degenerative arthritis of the hip. When a dislocation has remained unreduced, or has recurred after treatment in childhood, the problem is a more complex one in which instability of the hip, shortening of the leg and spinal deformity are important. Pain in the hip is usually, but not invariably, associated with the onset of degenerative arthritis, and it is the onset ofpain which drives these patients to seek surgical relief. Although it is undoubtedly true that many adults with a persistent dislocation of the hip pass their lives without demanding orthopaedic treatment, most are severely disabled, and even in the absence of arthritic changes their difficulties increase with age. It is against this background of a progressive locomotor disturbance that the results of surgical treatment must be judged.