[Surgical treatment of congenital dislocation of the hip in older children; analysis of the results. Apropos of 46 cases].

The results of surgical treatment of 46 congenital dislocations of the hip in children older than 4 years are analysed. Several techniques were used; progressive traction for a short time, stabilisation by plaster cast immobilisation or surgical reduction, pelvic osteotomy with or without combined femoral rotation osteotomy with shortening. Apart from other means of assessment, 3 radiological signs were used to determine the results - sphericity of the femoral head, coverage of the femoral head and centering of the femoral head. A new classification is proposed by the authors. Only 25 p. 100 of the results were excellent or good. The other hips had at least one radiological anomaly and 17.5 p. 100 of the hips had a non-spherical head. Cases with poor coverage of the femoral head did well when this was the only defect because this anomaly was easily corrected. In contrast, excentration of the femoral head was poorly tolerated in the long term. The degree and direction of excentration had to be assessed in the frontal plane.