I recall the feeling of satisfaction when, shortly after reduction of a congenital dislocation of the hip, I was unable to distinguish from physical examination alone which of the two hips had been dislocated. As these children returned for follow up examinations it was observed that they continued to have good function and no limp, but the roentgenograms were beginning to show abnormalities when closely compared with those of a normal hip. A few years later still these differences from the normal on the roentgenogram were becoming more marked. Frequently a patient would complain of pain on excessive use of the hip and not be entirely symptom free under the strenuous activities of normal childhood.
This induced me to consider whether or not the treatment was at fault, particularly in the face of published reports of end results at other clinics. I shall not go into detail to quote these
HEYMAN CH. LATE RESULTS OF TREATMENT OF CONGENITAL DISLOCATION OF THE HIP. JAMA. 1936;106(1):11-16. doi:10.1001/jama.1936.02770010013003