Evaluation of the results of operative treatment of hip dysplasia in children after the walking age

Background: Treatment of neglected developmental dysplasia of the hip (DDH) in children after the walking age has been a challenge to the orthopedic surgeons. It is usually surgical at this age group. Methods: The study included 35 patients (42 hips), they had been treated by different combinations of open reduction, femoral (shortening, derotation and varus) and pelvic (Salter or Dega) osteotomy. The age at the time of the operation ranged from 18 to 96 months. Results: At the end of follow-up (a mean of 33.5 months), the overall final clinical result was excellent in 13 (31%) patients, good in 24 (57%) patients, fair in four (9.5%) patients and poor in one (2.5%) patient satisfactory in 37 (88%) patients and unsatisfactory in five (12%) patients. The radiological end result was Class I (excellent) in 26 (62%) patients, Class II (good) in 11 (26%) patients, Class I (fair) in three (7%) patients and Class IV (poor) in two (5%) patients. It was satisfactory in 37 (88%) patients and unsatisfactory in five (12%) patients. Conclusion: We concluded that operative treatment of neglected DDH after the walking age is a technically demanding procedure but when performed properly by an experienced surgeon it gives satisfactory results.