Mechanisms of acetabular growth in the foetus in relation to the pathogenesis and treatment of congenital dislocation of the hip.

The development of the acetabulum has been studied histologically and histochemistry from the beginning of the foetal period to birth. The acetabular roof develops by interstitial growth of the acetabular cartilage and the limbus, enchodral ossification of the growth cartilage of the acetabulum and periosteal ossification of the iliac ala. In congenital dislocation of the hip (C.D.H.) this mechanism is altered but can be restored to normal by stable reduction during the first 4-5 years of life. Plastic operations to create a new roof ("shelf operations") are often destined to failure because they can not only damage the delicate histological structures concerned in the growth of the acetabulum, but the bone grafts used do not grow like the neighbouring osteocartilaginous structures.