The treatment of old unreduced traumatic dislocations of the hip

Old unreduced traumatic dislocations of the hip present great difficulties in management, especially in countries where implants for reconstructive surgery are not readily available. Eleven patients were initially treated with continuous skeletal traction of 10-30 kg for a period of 3 weeks. All of five type I dislocations, were reduced by this method even though there had been 3 weeks-6 months delay before treatment. By contrast, traction was not successful in three Type II and three Type III dislocations even after extensive surgical mobilization of the head and neck of femur because they were so much more serious injuries. Acceptable results were achieved in these cases after arthrodesis or excision arthroplasty and excellent results comparable to those achieved by implants followed by temporary transfixion of the hip joint. From our experience of these results, we believe that the traditional pessimism about the effects of old, unreduced traumatic dislocation of the hip is not justified.