PubMed · 5889169
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J T Bate. A functional lumbosacral back support.. https://pubmed.ncbi.nlm.nih.gov/5889169/
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We report the results of 113 early open reductions of congenitally dislocated hips using a technique we have developed. Surgery is followed by functional postoperative treatment with a Pavlik harness or abduction splint. The age of the patients and the follow-up period ranged from 6 to 24 months and 2 to 12 years, respectively. Radiologic results corresponded to Severin grades I and II in 98%. Severe ischemic necrosis was not observed. Secondary surgery (femoral derotation osteotomy and/or Pemberton's operation) was performed in 21% of the cases. Reduction at a young age resulted in fewer secondary procedures. Good results were attributed to postoperative treatment: Abandoning rigid fixation prevented soft tissue stretching, which may endanger blood supply to the joint. This treatment ensures concentric reduction and allows early and spontaneous joint mobilization in a functional position. These factors stimulate further joint development.
Hypothetical assumption, based on phylogenetic, anatomical and epidemiological studies as well as on clinical findings led the author to the conclusion, that regardless of an etiologic factor and the duration of its action the chief determinant for preserving the curve is the contracture of the short muscles and ligaments of the spine backed by scoliosis action of the long spinal muscles. Taking this into consideration the author has developed a method for small angle scolioses treatment by means of gravitational counteraction and removal of mainly ligamentous contracture of the spine. That can be accomplished by flexion-rotation exercises supplemented by "segmental gymnastics". The principles are validated by 30 years of clinical experience and advantageous results.