Varus-Producing and Derotational Subtrochanteric Osteotomy in the Treatment of Congenital Dislocation of the Hip

¹ From the Shriners' Hospital for Crippled Children, Portland

The analysis of the results to date of fifty-nine varus osteotomies with or without derotation to correct anteversion done for congenital dislocation and subluxation of the hip indicates that the following advantages are obtained:

1. The procedure permits complete concentric reduction of the femoral head;

2. The dynamic and static forces maintaining reduction of the hip are improved;

3. As a result of advantages 1 and 2, greater stability is obtained and maintained:

4. The tendency to subsequent subluxation is reduced (there have been no redislocations in this series):

5. The incidence of aseptic necrosis is decreased;

6. The surgically produced varus position—a neck-shaft angle 90 to 100 degrees—tends with growth to return to a normal neck-shaft angle;

7. The varus position is easily produced at the time the derotation osteotomy is done to correct anteversion:

8. Complications are minimum;

9. The necessity for further surgical procedures is reduced.

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