Varus Derotational Osteotomy and Shortening of the Femur in Treatment of DDH after 18 Months of Age

In patients with late diagnosis of DDH after open reduction of the hip joint، we can use pelvic osteotomy or varus-derotational osteotomy (VDO) of the femur to make the open reduction more stable. The goal of the present study is to report on redirection of the femoral head towards acetabulum by femoral osteotomy. In this prospective study we performed only VDO in 67 hips in 46 patients (36 females، 10 males) after open reduction of the hip in cases of 18 months to 10 years of age whom Salter innominate osteotomy was needed in a hospital in Ahvaz، Iran. The patients were followed up until complete weight bearing and plate removal. Concentric reduction was achieved in 67 hips. Acetabular index showed 6 degrees of reduction after 26 months. No redislocation was seen after plate removal in 61 hips (91%) but pelvic osteotomy was done in 6 hips (9%) due to redislocation or residual displasia. Ninety percent of patients were classified as group 1 or 2 in «severin» classification. VDO is a simple operation with low complication rate. Although more than 90% success rate was observed in these patients، in order to see possible residual dysplasia in these patients longer follow-ups are needed.