The surgical treatment of developmental dislocation of the hip in older children: a comparative study.

The aim of this retrospective study was to compare simultaneous open reduction and Salter innominate osteotomy versus one-stage combined surgical treatment including femoral shortening. A total of 24 patients were studied. Group 1 included 16 hips in 14 patients treated by simultaneous open reduction and Salter innominate osteotomy; Group 2 included 13 hips in 10 patients treated by one-stage open reduction, Salter innominate osteotomy and femoral shortening. The average age at the time of operation was 4.1 years (range: 3.3 to 5.1). Average follow-up was 5.3 years (range: 2.7 to 9.0). Clinical and radiological assessment at final follow-up showed that the outcome was not significantly different between the two groups. The duration of operation, however, was significant different between the groups. Patients with DDH between 3 and 5 years of age were treated successfully with either simultaneous open reduction and Salter innominate osteotomy or a one-stage combined surgical procedure including femoral shortening. Clinical and radiological outcomes were similar. Nevertheless, after this follow-up period, the rate of avascular necrosis was slightly higher in Group 1; on the other hand, one-stage combined surgical treatment including femoral shortening significantly prolonged the operative time.