Radical reduction operation in the treatment of congenital dislocation of the hip. An analysis of 2,789 cases.

During the period 1960 to 1983, 2,789 operations were performed in patients with congenital dislocation of the hip. Of these, 784 patients were between 1 1/2 and 4 years of age, 1,646 patients were between 4 and 8 years of age, and 359 patients were between 8 and 14 years, with an average age of 10 years. The procedure is performed in a single operation by sectioning all contracted muscles, opening and debriding the joint, and reducing the femoral head into the acetabulum after removal of 2 cm to 3 cm bone segment from the subtrochanteric region of the femur. Fixation of the femoral shaft in a derotation, varus position is done with a bone plate. Finally, a transiliac acetabuloplasty is performed. The bone segment removed from the subtrochanteric region is used to support the acetabular roof. The results, graded according to Severin's classification, were 83.3% successful and 16.7% unsuccessful.