The Journal of Bone and Joint Surgery, Vol 77, Issue 7 990-997, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
The acetabular response to proximal femoral varus rotational osteotomy. Results after failure of post-reduction abduction splinting in patients who had congenital dislocation of the hip
PL Schoenecker, DJ Anderson and AM Capelli
St. Louis Shriners Hospitals for Crippled Children, Missouri 63131, USA.
The acetabular response to proximal femoral varus rotational osteotomy was
studied radiographically in twenty-eight patients who had had thirty-three
congenitally dislocated hips. All of the patients had previously been
managed with open or closed reduction followed by use of a spica cast and
had worn an abduction orthosis for at least one year after the reduction.
The indications for the femoral osteotomy were a persistently increased
acetabular index or subluxation, or both. The average of the patients at
the time of the femoral osteotomy was twenty-five months. The average
preoperative acetabular index was 32 degrees. At an average of seven years
after the osteotomy, the acetabular index had improved to an average of 16
degrees. Four hips had had one subsequent procedure for persistent
acetabular dysplasia. Despite a failure of the acetabulum to respond to use
of an abduction splint, the proximal femoral varus rotational osteotomy
stimulated improvement in the acetabular index to within normal limits in
twenty-nine of the thirty-three hips.