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The Journal of Bone & Joint Surgery British Volume
Vol. 54-B, Issue 1 | Pages 4 - 12
1 Feb 1972
Mitchell GP

1. Some problems in the early diagnosis and management of congenital dislocation are discussed.

2. In a well-staffed maternity unit one dislocation completely escaped early detection in every 8,000 births over the period 1962 to 1968 inclusive.

3. The complications of early treatment on a Malmö splint are initial failure to obtain reduction, failure to maintain reduction, deformity of the upper femoral epiphysis or metaphysis, and persistent anteversion of the femoral neck.

4. Arthrography suggests that failure of early splintage and deformity of the upper femur are due to attempted reduction in the presence of an inverted limbus.

5. A trial method of treatment of frank displacement in the first year of life has been carried out by combining excision of the inverted limbus with a period in a frog position plaster to correct anteversion. This method avoided changes in the upper femur but failed to correct anteversion in four out of eighteen cases.


The Journal of Bone & Joint Surgery British Volume
Vol. 49-B, Issue 2 | Pages 281 - 287
1 May 1967
Mitchell GP Gibson JMC

1. The results of excision of calcaneo-navicular bars in spasmodic flat feet are reported. The average follow-up was six years. Complete relief of symptoms was achieved in 68 per cent and over 25 degrees of subtalar inversion was restored in 58 per cent of the feet.

2. The results appear slightly more favourable than those of conservative treatment, but it is realised that the period of observation is short.

3. In a selected group of patients operation by a standard technique relieved symptoms and restored subtalar movement in all.

4. It is submitted that excision of the calcaneo-navicular bar is a justifiable procedure in the younger patient with painful spasmodic flat foot of recent origin.


The Journal of Bone & Joint Surgery British Volume
Vol. 45-B, Issue 1 | Pages 88 - 95
1 Feb 1963
Mitchell GP

1. The technique of arthrography in congenital displacement of the hip is described. No complications have been encountered in a series of over 200 examinations. The interpretation of the arthrographs is discussed.

2. It is suggested that the abnormal hips may be classified in three degrees: 1) Primary instability; 2) partial displacement without interposition of soft tissue; 3) complete displacement with interposition of soft tissue between head and socket.

3. Two types of complete displacement or dislocation are recognised: 1) the "tight" dislocation; 2) the "loose" dislocation. In the latter there is marked displacement of the femoral head, and arthrography done before reduction demonstrates interposition of a fold of capsule lying in front of the inverted limbus.

4. Arthrography is of special help in making the diagnosis between partial displacement with eversion of the labrum and "tight" dislocation with an interposed limbus. It is helpful too in establishing the cause of failure of reduction.


The Journal of Bone & Joint Surgery British Volume
Vol. 36-B, Issue 1 | Pages 114 - 115
1 Feb 1954
Boldero JL Mitchell GP