One can classify normal human variations into that which is mostly due to genetic difference, that which is mostly due to differing environmental experience, and that which is a combination of both genetic and environmental difference.'
C O Carter (1962)
Although Hippocrates (460-370 BC) was reported to have recognised persons that had experienced dislocations of their hips in utero, separating them from those with acquired and more painful dislocations, it was not until 1847 that the first description of the classical features of the deformity in the newborn, older children and adults was recorded by Baron Dupuytren.1 He noted that they were commoner in girls and also appeared to have family concentrations. He believed that these congenital dislocations were due to accidental displacements of the hip joint in utero. He concluded that they were the result of the foetal thigh 'being very much bent on the belly', from which it followed that the heads of the thigh bones were continually pressing against the lower part of the capsular ligament; 'a circumstance which, though without effect in well formed individuals, might, I apprehend, have an injurious influence in such as are weak or of lax resisting fibre'. So Dupuytren was aware of the congenital nature of the deformity, its sex distribution and familial concentrations, as well as the prime aetiological factors, breech malposition and joint laxity.1
The first detailed study of the epidemiology of C D H was published in 1895, 2 following the introduction of radiology by Roentgen. Experimental arthrography