Effects of Open Reduction and Varus Osteotomy of Femur in Children with Congenital Dysplasia of the Hip

Delayed closed reduction in a child with congenital dysplasia and dislocation of the hip (DDH) results in secondary degenerative changes in acetabulum and head of the femur, which prevents normal development of the hip. The goal of this study was to study surgical results of reduction of the hip and femoral varus osteotomy and its effect on acetabulum index correction in children with DDH. The present study was performed on 25 children aged 1-2 years with congenital dysplasia and dislocation of the hip who underwent open reduction through anterior approach incision and femoral varus osteotomy in Imam Khomeini and Shohada hospitals, Tabriz, Iran between 1988 and 1998. Postoperatively all the patients were assessed for acetabulum index, center-edge angle of the femur, range of motion of the hip and possible postoperative complications within 10-year follow-up. There was neither avascular necrosis nor movement limitation of the hip. In one of the patients unilateral coxa valga was developed in the leg undergone surgery. Two of affected hips were dysplastic after 10 years. In the remaining cases, acetabulum had a normal shape and in comparison to opposite leg, there were no significant changes. The results suggested that after open reduction of a developmental dislocated hip in children aged 1-2 years, the decision for reconstruction of the acetabulum should be delayed at least for 3 years.