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EXTRA-ARTICULAR BONE-GRAFT TREATMENT FOR TUBERCULOSIS OF THE HIP JOINT With a Special Study of the Primary Failures of Fusion
SYLVAN L. HAAS
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The Shriners' Hospital for Crippled Children
The Journal of Bone & Joint Surgery.  1933; 15:743-751 
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Abstract

1. The extra-articular-graft method for fixation in tuberculosis of the hip joint in children is a definite, curative, operative procedure and reduces markedly the time of treatment.

2. In the primary successful cases, the patients were able to walk unaided one and one-third years after operation, although the average duration of the disease before operation was nearly five years.

3. The longest lapse of time since operation in this series is eight years. There is every indication of permanent cure in this and the other cases of the series.

4. Successful results may be obtained even though a sinus or abscess is present at the time of operation, but a clean field is preferable.

5. Forty per cent. of the patients required more than one operation before successful result was obtained.

6. The failure of the primary operation was found in the acute cases of short duration, in which there was little destruction of the head and involvement of the acetabulum, adduction deformity, and considerable free movement in the joint at the time of the operation.

7. In those cases where a primary failure may be anticipated, it is recommended that a supplementary osteoperiosteal graft from the tibia or upper end of the femur be used in conjunction with the graft from the ilium.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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