Long-term results of combined operative reduction of the hip in older children.

Long-term results of open reduction, combined with femoral shortening, iliac osteotomy, reorientation of the upper femur, and medial iliopsoas transfer, are analyzed in 144 hips, according to patients' answers to follow-up questionnaires. Age at surgery ranged from 7 to 15 years with a follow-up of 9-24 years (mean 13 years). Two-thirds of patients had good results, one-fourth had fair results, and one-tenth had poor results. This was in accordance with radiologic rating in 225 hips, with a mean follow-up of 5 years. Quality of results decreased with age at surgery. The combined procedure is not advised after the appearance of pubertal signs. Since radiologic results favored Chiari's iliac osteotomy and subjective results favored the Pemberton type, individual choice is advised, according to the severity of acetabular dysplasia and the age of the patient. Redislocations, when left alone, had better results than did hips that were operated on again.