Ponseti's 1978 anatomical study examines the acetabular pathoanatomy of congenital hip dysplasia through autopsy dissection of six dysplastic infant hips (gross, histological, and histochemical analysis) and radiographic follow-up of 180 closed reductions, asking what structures form the acetabular ridge, how to diagnose dysplasia clinically, and how timing of reduction affects acetabular development.
When examining a newborn's hip, a click alone is not diagnostic — only the jolt of a true positive Ortolani sign (femoral head sliding over the neolimbus) warrants treatment, and treating click-only hips risks harm.
At open reduction, the arthrographic 'filling defect' is usually a cartilage bulge rather than an inverted labrum, so routine limbus excision is not indicated and may damage epiphyseal cartilage; reserve labral removal for the rare severe (teratological) dislocation where a truly inverted hypertrophic labrum blocks reduction.
Ponseti's 1978 anatomical study examines the acetabular pathoanatomy of congenital hip dysplasia through autopsy dissection of six dysplastic infant hips (gross, histological, and histochemical analysis) and radiographic follow-up of 180 closed reductions, asking what structures form the acetabular ridge, how to diagnose dysplasia clinically, and how timing of reduction affects acetabular development.
When examining a newborn's hip, a click alone is not diagnostic — only the jolt of a true positive Ortolani sign (femoral head sliding over the neolimbus) warrants treatment, and treating click-only hips risks harm.
At open reduction, the arthrographic 'filling defect' is usually a cartilage bulge rather than an inverted labrum, so routine limbus excision is not indicated and may damage epiphyseal cartilage; reserve labral removal for the rare severe (teratological) dislocation where a truly inverted hypertrophic labrum blocks reduction.