One-stage treatment of congenital severely dislocated hips in older children through various acetabuloplasty techniques: 22 children followed for 1-5 years.

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 degrees (35-65) preoperatively, at the last follow-up it was 30 degrees (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.