Operative Procedures in Children with Congenital Residual Subluxation of the Hip

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In our clinic subtrochanteric osteotomy is performed in children aged about two years with congenital residual subluxation of the hip.The osteotomy allows changes in the neck-shaft angle, the torsion and the anteversion. The direction of the osteotomy runs obliquely from the frontal surface of the femur distally posteriorly, and then two procedures are done according to the femoral head-neck deformity.In the valgus deformity the femur is cut in a position of internal rotation. Thereafter the distal fragment is outward rotated and adducted. The osteotomized site is fixed with a plate and four screws.Correction of anteversion deformity is achieved by both adduction and external rotation of the distal fragment after the osteotomy. The authors must emphasize retroflexion of the femoral head and neck accompanied with the latter procedure.To ensure a physical remolding of the femoral head and neck, apophysis is not injured and the plate is removed three or four monthes after the surgical treatment. Postoperative immobilisation is kept with indirect extention (2Kgm) for about three weeks.
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