Congenital dislocation of the hip. Case report of an unusual complication and unusual treatment.

A case of congenital dislocation of the hip is reported in which initial closed reduction during infancy was apparently successful but atypical changes in the femoral head, coxa vara, and shortening of the femoral neck became apparent subsequently. Treatment by distal transplantation of the epiphysis of the greater trochanter and contralateral epiphyseodesis led to a very good result. The probable explanation of the complication is that there was partial vascular insufficiency in the unossified femoral head, due to injury to the epiphyseal vessels, particularly on the medial side, and that the metaphyseal changes were secondary to asymmetrical growth disturbances in the epiphyseal plate.