Developmental hip dysplasia: which osteotomy, when?

Abstract

Developmental hip dysplasia is a common problem encountered in orthopaedic practice; early diagnosis and closed containment of the femoral head in younger children aims to allow remodelling to occur. For older children, with less remodelling potential, surgical intervention with femoral and/or pelvic/acetabular osteotomies may be required. There are many osteotomies described, all with a common goal of normalizing anatomy and preventing long term degenerative changes. Individual osteotomies can be classified as redirectional or salvage subtypes, then indications by the age of the child/degree of skeletal maturity. The osteotomy options and outcomes from available literature are explained and a flowchart to summarize the authors recommended choices is provided.