Treatment of hip dislocation after walking age.

Between 1979 and 1981, 35 patients were treated at our institution. All patients were more than 18 months of age and 50 congenitally dislocated hips were treated. The average age at operation was 7 years and 3 months. Whereas children under the age of 6 were typically operated upon by open reduction and Salter, Pemberton, or Dega osteotomy partly combined with femoral osteotomy, in the group of the patients older than 6 years with high iliac hip dislocations, a method was used to avoid femoral shortening. By means of the Wagner distractor the dislocated hips were brought opposite to the acetabulum. This procedure was followed by femoral osteotomy and in most cases Chiari pelvic osteotomy. Despite a number of complications the results turned out better than expected. Compared with the preoperative X-ray classifications (Severin) the postoperative result was excellent in 10 cases, good in 20, fair in 15, and poor in 1 case.