Pathogenesis of Congenital Hip Dysplasia (CDH). A Proposal

Key words

Congenital hip - Dysplasia - Cartilage growth - Children’s deformities - Biomechanics

• REFERENCES

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• 62 Some recent texts and articles stated without documentation that in the past century Delpech, Heuter and Volkmann realized that, depending on their size, compression loads could retard or accelerate chondral growth. The author and a dozen other international authorities could not find the original references in an equal number of university libraries. However Drs. B. N. Epker of Fort Worth, TX, and F. O’Ryan of San Francisco, CA, did find one reference for Heuter and Volkmann each, published in German texts in the 1850s and 1860s. The Library of Congress graciously made the originals (in German) available and Dr. Klaus Anselm of the Southern Colorado Clinic translated them. Their texts revealed that both gentlemen found the matter confusing, in large part because they did not have available the modern radiological methods and basic clinical and experimental anatomical, histological, biomechanical and pathological experience, knowledge and insights available to us today. Could it be that no Delpech-Heuter-Volkmann chondral modelling “laws” ever existed, and that authors simply repeated statements of predecessors who thought they did? That did explain the false notion that spondylolysis represents a failure of separate vertebral ossification centres to fuse, for no such separate centres exist in the pars interarticularis.