ABSTRACT
Treatment of DDH after walking age is a point of controversy and raise a lot of questions. The material included 17 hips in 14 patients [10 females and 4 mails].Right hip was affected in 8 patients while the left hip was affected in 3 patients; bilateral dislocation in 3 patients. All cases were discovered late when patients started to walk and presented with limping or waddling gait. The age of our patients ranged between 1.5-3 years old. In this age group there are adaptive shortening of the extra-articular soft tissues, acetabular dysplasia, capsular constriction, and increased femoral antiversion. All cases did not receive any previous treatment. Combining derotational femoral shortening osteotomy with open reduction to reduce the incidence of redislocation and avascular necrosis [A VN] were done for all cases. K wire fixation was added between the greater trochanter and the hip bone. The average follow up was 2 years. All patients were evaluated clinically on the basis of rang of motion 9hip stability, limp and pain.Clinically,16 cases were scored excellent according to the modified Mckay criteria.One case developed avascular necrosis. We concluded that Femoral osteotomy [varus derotation and shortening] with open reduction is an effective and recommended approach for treatment of DDH in patients who had begun to walk. The use of K-wire helps maintaining the reduction during femoral osteotomy and during changing of the cast