"Radical reduction" procedure for treatment of congenital dislocation of the hip in older children.

During the period 1962-76, 1,500 operations were performed in patients with congenital dislocation of the hip. Of these, 420 patients were aged between 6 and 13 years (average age, 10 years). The procedure is to perform in a single operation the sectioning of all contracted muscles, the opening and cleaning of the joint, and the reduction of the femoral head into the acetabulum after removal of a bone segment 2 to 3 cm long from the subtrochanteric region of the femur. Reunion of the femoral shaft in a derotation varus position is then done with a bone plate and, 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.