One-stage treatment of neglected congenital dislocation of the hip

ABSTRACT

One-stage operative procedure for neglected congenital dislocation of the hip in 16 children [18 hips] was evaluated in this study. Nine patients had dislocation of the left hip, five had dislocation of the right and two had bilateral dislocation. None of the patients had a previous treatment of the dislocation. The average duration of follow up was 2 years and 11 months. Open reduction with shortening and derotation of the femur was done for all hips. In nine hips, varus angulation, for excessive valgus, was added to the osteotomy. Salter innominate osteotomy was performed in ten hips. According to Severin's system for radiographic evaluation, 14 hips had excellent or good results. The range of motion was assessed using the rating system of Ferguson and Howorth. Ten hips were excellent, five were good, two were fair and one was poor. Avascular necrosis was developed in one hip which gave a fair clinical result. A limb- length discrepancy of more than 1 cm [2.2 cm] occurred in one patient at the latest follow up. In one hip, instability, which led to subluxation, developed postoperatively which needed operative revision and the capsulorrhaphy was tightened