Primary anterior congenital dislocation of the hip in infancy

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McCarroll-HR; McCarroll-HR Jr J-Bone-Joint-Surg-Am. 1980; 62(4): 554-6 Primary anterior congenital dislocation of the hip can be diagnosed in infancy as an entity distinct from the more common posterior dislocation. Anterior dislocations are characterized by a visible and palpable fullness in the femoral triangle, marked limitation of abduction, a severe pelvic tilt or obliquity, marked apparent shortening of the linb on the involved side, absence of telescoping, and a rest position of external rotation. Conservative treatment is recommended. An abduction splint should be used to minimize the adduction contracture before a closed reduction is performed under general anesthesia. The position of a stable reduction is one of flexion, abduction, and internal rotation. Immobilization in a spica cast is required for six or seven months. Most patients will require a derotation osteotomy for correction of anteversion of the femoral neck during this time.