[Femur remodelling procedures following osteotomies at the coxal end of the femur in the treatment of congenital dislocation of the hip (author's transl)].

This paper was prepared on the basis of 801 case histories (1019 hips) of children treated for congenital dislocation of the hip in our clinic during the last 25 years. Over the years a variety of surgical methods have been employed in the clinic in the treatment of congenital dislocation of the hip, such as open repositioning (with detorsion osteotomy), reconstructive repositioning after Colonna-Zahradnicek, and in recent years open repositioning with pelvic osteotomy. All these interventions were always accompanied by osteotomy of the coxal end of the femur. The type of osteotomy performed depended on requirements: detorsion osteotomy without altering the diaphysis-collum angle (CCD), detorsion varisation adduction osteotomy with or without shortening of the femur. If the need for detorsion osteotomy is completely beyond doubt, we believe that adduction is usually unnecessary and sometimes even detrimental, especially in cases with preoperative growth disturbances of the proximal epiphysis and metaphysis. In none of the cases with permanent inhibition of growth of the acetabular margin did the adduction operation (varisation) have a favorable effect on hip development. Detorsion osteotomy without adduction (and if necessary with abduction) and with simultaneous pelvic osteotomy is the best point of departure for subsequent physiological development of the hip in children.