Primary anterior congenital dislocation of the hip can be diagnosed in
infancy as an entity distinct from the more common posterior dislocation.
Anterior dislocations are characterized by a visible and palpable fullness in
the femoral triangle, marked limitation of abduction, a severe pelvic tilt or
obliquity, marked apparent shortening of the limb on the involved side,
absence of telescoping, and a rest position of external rotation.
Conservative treatment is recommended. An abduction splint should be used
to minimize the adduction contracture before a closed reduction is performed
under general anesthesia. The position of a stable reduction is one of
flexion, abduction, and internal rotation. Immobilization in a spica cast is
required for six or seven months. Most patients will require a derotation
osteotomy for correction of anteversion of the femoral neck during this
time.