Primary anterior congenital dislocation of the hip in infancy.

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.