Contractures of the hip joint occur from chronic muscle spasm or chondrolysis. The hip joint can compensate for flexion contractures to a certain extent by increasing lumbar lordosis. Abduction and adduction contractures cause the pelvis to be uneven causing apparent leg length difference. Rotational contractures fix the leg in inward or outward rotation.
As contractures are from soft tissue stiffness, attempts at stretching with exercises and physiotherapy should be tried first. Forceful stretching can cause fractures of weak bones. Persistent and disabling contractures can be treated by releasing all tight structures except for the vital nerves and blood vessels. Inadequate correction in spite of good soft tissue release can be compensated by femoral osteotomy.