The complications of Salter innominate osteotomy in the treatment of congenital dislocation of hip.

In the management of congenital dislocation of the hip, a common problem in our country, a high success rate can be achieved by using conservative treatment in children less than 1 year of age. Unfortunately, most cases are seen too late for conservative management and surgical treatment must be used. Open reduction and Salter innominate osteotomy have been used routinely in our department for children from 18 months to 6 years of age. Between the years 1970 and 1985, 229 hips in 164 children (141 girls and 23 boys) were treated by this method and were followed up in our department. Of these 164 children, 65 (39.6%) had bilateral involvement, 59 (35.9%) had a dislocation of the left hip and 40 (24.3%) of the right hip. We reviewed the technical errors and complications encountered in the treatment of these children: Inadequate rotation of the distal fragment after osteotomy was noted in 9 cases (3.9%), inadequate placement of the pins was seen in 17 cases (7.4%), resulting in secondary displacement of the graft in 5 (2.1%), redislocation of the hip in 13 (5.6%), hematomas and superficial infections were noted in 12 cases (5.2%), deep infections in 3 (1.3%), persistant stifness of the hip joint in 9 (3.9%), femoral fractures in 2 (0.8%) and avascular necrosis of the femoral head in 18 (7.8%). The pathogenesis and possible prevention of these complications are discussed.