Lateral Tethering of the Proximal Femoral Physis Complicating the Treatment of Congenital Hip Dysplasia

Summary: One hundred forty-two consecutive patients treated at the Portland Shriners Hospital from 1975 through 1984 for congenital hip dysplasia were reviewed. Fourteen patients (10%) with 18 lateral physeal tethers were identified; three tethers occurred in the uninvolved hip. The lateral bridge was apparent at an average of 8 years. Age at initial treatment averaged 10 months and, at follow-up, 10 years. Fourteen of the tethers occurred in the treated hip, five after open reductions, and seven after closed reductions. Lateral physeal tethering is an iatrogenic entity. Knowledge of this condition should lead to early recognition and prevention of the secondary deformities.