[Salter's innominate osteotomy in the treatment of congenital dislocation of the hip. Apropos of 129 cases].
The authors studied a series of 129 innominate osteotomies performed for the treatment of a congenital dislocation of the hip (C.D.H.) in 109 children. This procedure was performed at an average 26 months age and its result reviewed after 6 years and 2 months in average. The innominate osteotomy was most of the time performed after the conservative treatment of the dislocation and an articular procedure was only necessary 19 times out of the 129 hips. In 14 cases, an external derotation of the femur was associated to the pelvic osteotomy. The analysis of the results showed an excellent correction of the acetabular dysplasia as much by the improvement of the femoral head as by the decrease of the obliquity angle of the acetabular roof. At the maximum follow-up, 90.3 per cent excellent and good were counted and the results in 9.7 per cent of the cases were poor. Among these 12 poor results, 9 were caused by a technical surgical fault. The femoral antetorsion decreased in a large majority of the cases. The study of the 28 cases with an over 12 years follow-up showed that good results were time proof. The authors discuss about the criteria that may indicate surgery before 3 years. Those may only be determined on the basis of some abnormalities which remain after the conservative treatment: acetabular morphology, concentricity of the articular surfaces, femoral antetorsion and social problems.