Combined procedure of open reduction and shortening of the femur in treatment of congenital dislocation of the hips in older children.
A one-stage, combined operative procedure for reduction of congenitally dislocated hips in older children consists of shortening of the femur; open reduction by an inferior approach to the joint; reconstruction of the acetabular roof; correction of anteversion of both the femoral neck and the neck-shaft angle; anterior transposition of the iliopsoas muscle. On 60 hips operated in children, ages 5 to 15 with a follow-up period, ranging from 5 to 9 years, the results were found to be excellent in 3 per cent, good in 60 per cent, fair in 30 per cent, and poor in 7 per cent. The procedure is indicated in children up to the time of early puberty. The primary indication is high bilateral dislocation. In unilateral dislocations some residual leg-length discrepancy frequently occurs. This procedure should be done only by orthopedic surgeons who have special training and experience in the treatment of congenital dislocation of the hip.
D000077:Acetabulum / Q000033:anatomy & histology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000601:surgery*; D005270:Femur Head / Q000033:anatomy & histology / Q000473:pathology; D005272:Femur Neck / Q000033:anatomy & histology; D005500:Follow-Up Studies; D005684:Gait; D006615:Hip / Q000502:physiology; D006618:Hip Dislocation, Congenital / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000033:anatomy & histology; D008297:Male; D008722:Methods