One-stage treatment of congenital severely dislocated hips in older children through various acetabuloplasty techniques

Abstract

Background There is no consensus regarding the best treatment for children with late diagnosis of congenital hip dislocation. Patients and methods This retrospective study involved 29 hips in 22 children (19 girls) with an age range of 3–14 years, who had been operated with various techniques for congenital hip dislocation between 1998 and 2002. 6 patients had right, 9 patients had left, and 7 patients had bilateral congenital hip dislocation. The mean length of follow-up was 3 (1–5) years. Results While the mean acetabular index was 53°(35–65) preoperatively, at the last follow-up it was 30° (15–50). 27 hips were type 4 and 2 hips were type 3 by Tönnis criteria. Satisfactory reduction (Severin Class I) had been achieved in 19 hips at the follow-up radiography, and they developed no osteonecrosis. The outcome was successful in children under 7 years of age, but problems encountered in those over 7 increased unless sufficient reduction had been achieved. Interpretation Age at treatment of late-diagnosed congenital hip dislocation appears to be important for outcome.