[First-choice orthopedic treatment in congenital hip dislocations discovered after walking age]

The incidence of late discovery of congenital dislocation of the hip is getting lower, thanks to systematic screening. We have treated 14 children during the past 5 years. Clinical diagnosis was confirmed by radiography. Thirteen children were treated by slow reduction, and immobilization according to Somerville-Petit's method. Four surgical treatments were performed (1 Klisic operation by first intention, 3 Salter operations by second intention). Good clinical results have not always correlated with radiologic normalization. These results were evaluated by Séverin's classification: 9 excellent or good (I or II), 4 poor results (III). Although improvement is expected in the future, repeated clinical and radiological supervision permits evaluation of the indications for a subsequent operation at the most favorable time.