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May 12, 1962

Ischemic Necrosis Following Treatment of Hip "Dysplasia"

JAMA. 1962;180(6):497-499. doi:10.1001/jama.1962.03050190000014e

ALTHOUGH HIP ABNORMALITIES of infancy are incompletely understood, much progress has been made. Within the general category of congenital hip disease, workable criteria have been advanced both clinically and roentgenologically, for dislocation, preluxation, and adductor tightness. Indication for therapy have become better defined. However, there is still some uncertainty, and an attitude of "if in doubt, treat to be on the safe side" persists. It is the purpose of this report to show that some forms of treatment may be harmful, and that improper diagnosis combined with such therapy may result in making a cripple out of a normal child.

The history of efforts to diagnose dislocation before it occurs goes back many years. Palmen has reviewed it in detail. Only a brief recounting will be given here. In 1925 Hilgenreiner suggested the name "dysplasia" to indicate a congenital malformation of the joint and also described a sound made as