The role of valgus osteotomy in LCPD.

When the hip is noncontainable due to established hinge abduction, restoration of joint congruity and/or acetabular volume should be the primary goal of treatment. Various salvage procedures have been attempted for the management of noncontainable hips, but no long-term follow-up data have been reported. A valgus osteotomy, which permits realignment of the leg with the hip in the "best fit" position in neutral weight-bearing position, has been most commonly applied to restore joint congruity and to reduce femoroacetabular impingement. Evidence continues to accumulate, indicating that valgus osteotomy, when combined with or without other salvage procedures, can result in sustained improvement of symptoms and function, and beneficially influences remodeling of the hip in a subgroup of children with hinge abduction.