SLOB

sway back. A lot of girl babies, BIG ones from all that excellent prenatal care and food availability - had flattened hips at birth, especially the left hip pressed against mom's spine. Breech babies – both sexes – commonly have one or both hips squished. Unlike flattened ears & noses from womb compression, the hips typically went unnoticed for a while. The age at which it “PRESENTED” [or adults sobered up & noticed] was anywhere from in the nursery to YEARS later. The early ones? Blame MOM = 'congenital'. The later ones? Blame nobody = 'developmental' having just kind of evolved. What?? Don't look at me! Orthopedics developed treatments to cover the range of discovered damage & displacement of the parts. The rate at which hip structure can repair shape limits self repair; bad for most late detection cases and some of the more severe early ones. Orthopedic literature is glutted with a rainbow of 'one & only' ways to treat these hips.

Academic egos aside, treatment got better and better as massive cumulative experience made it more & more difficult to deviate from whatever interventions had the best batting averages. How do you let a socket fully reform? One way was to hold the leg positioned and rotated such that the ball of the femur was exactly centered with no pressure pushing on the flat socket side and held

that way [with a body cast including leg(s)] for – oh – mmm – three YEARS!

What? Is that a problem? You bet it was. Many pediatric doctors hid the hip findings to spare children this [to them] assault on childhood. Untreated looked this way==> So, here we are – with Congenital dysplasia of the hip – or Developmental dysplasia of the hip CDH / DDH... YEARS in body casts?? To everything, turn turn, there is a season, turn turn …

One could cut the bone, and leave the upper part pointing as it was in the cast, but then move the rest of the leg to look like standing posture. Plate with screws, allows no cast, and go home. Everything good includes home. Right? The truth is that, so often, you can't go back home.