Eighteen children with unilateral dysplasia of the hip were found to
have asymmetrical gluteal folds and an apparent limb-length inequality
secondary to pelvic obliquity caused by an abduction contracture of the
contralateral hip. The dysplastic hip was on the left in all but one
patient. As a result of the pelvic obliquity, the femoral head on the high
side of the pelvis was directed superolaterally, stretching the relaxed
capsule still farther. The femoral head was then not concentrically
reduced, and the pressure it caused on the superior border of the labrum
contributed to the development of the acetabular dysplasia. The eighteen
dysplastic hips were treated with abduction splinting and stretching
exercises of the contralateral hip to decrease the abduction contracture.
All of the dysplastic hips returned to a normal roentgenographic appearance
with this treatment. Acetabular dysplasia without dislocation of the hip is
not always appreciated by clinical examination, but the asymmetry of the
gluteal folds and the apparent limb-length inequality that were seen in all
of the children in this series were obvious clinical signs. These findings
must be differentiated from the anterior thigh-fold asymmetry that is
frequently seen without underlying pathology.