Congenital hip dislocation: techniques for primary open reduction including femoral shortening

Combining primary open reduction, femoral shortening, capsulorrhaphy, and acetabuloplasty in a single operation allows predictable treatment of congenital dislocation of the hip in older children without the time and expense of preliminary traction. In addition to the bony abnormalities of congenital hip dislocation, the complex pathologic anatomy of the hypertrophied capsule and associated soft tissues must be recognized and corrected. Failure to treat all components of this condition often leads to reduction that is apparently satisfactory in the intraoperative and early postoperative periods but is followed by hip subluxation or redislocation with weightbearing. Correcting all components of the congenital hip dislocation deformity in a single operation provides the best opportunity for early return of normal hip mechanics and function in the older child.