Often these deformities are asymptomatic and alone do not require specific treatment. Fractures These are common in polio, and should be treated in the same way as fractures in patients without polio. The opportunity should be taken, however, to use the fracture to correct any existing deformity in the fractured limb. Dislocation or subluxation of the hips This is occasionally seen with severe paralysis of the hip muscles. It is more usual, however, after an extensive open division of the hip muscles and ligaments for a flexion deformity.
Dislocations require reduction and treatment by an abduction spica.
Some cases of recurrent dislocation are best left untreated. Others may require an osteotomy, an arthrodesis, or occasionally a psoas transfer. This may be associated with backward and lateral subluxation of the tibia, and also with lateral rotation of the tibial plateau. In children the subcutaneous methods of correction already described should be tried. In adults a painful stiff knee may often result, quite apart from the difficulty and time involved in straightening a severe longstanding contracture.