The Chiari osteotomy in the older child with congenital hip subluxation and acetabular dysplasia.

Six adolescent patients with acetabular dysplasia and femoral head subluxation were treated with Chiari osteotomy. The average age of the children was 14 years. The prior duration of the subluxation and dysplasia had resulted in mutual remodeling adaptations preventing concentric femoral head restoration. The Chiari osteotomy improved acetabular cover without significantly disturbing hip mobility in the existing modeling relationship. Postsurgical morbidity included delay in osteotomy healing, wound infection and sciatic nerve damage. Proper care was necessary to outline the osteotomy site so that the proximal iliac segment lay in proper juxtaposition for femoral head support after displacement. A variety of treatment choices is available for this category of hip derangement. The advantages and disadvantages of the Chiari osteotomy were listed.