Introduction

Some children may have conditions that affect their hip joint. 

The hip joint is made up of:

• the femoral head – the round top of the thigh bone
• the acetabulum – the cup-shared socket in the pelvis where the femoral head sits. 

The hip joint can move out of place as your child develops. Over time, this can lead to hip dislocation. Dislocation means the femoral head easily moves in and out of the socket. If the femoral head moves out of the socket and stays out, the hip will not grow normally. 

Tendons and muscles hold the femoral head in the hip socket. Some children who have weak muscles or can’t walk regularly may be at a higher risk of hip dislocation.

Varus derotation osteotomy (VDRO) is a procedure used to put the femoral head back in the correct position.

A child may need to have a VDRO if:

• their hip starts to move out of joint
• they are at risk of hip dislocation 
• they have a condition that affects the position of their legs
• they have a condition that affects the hip, like developmental dysplasia of the hip.

VDRO may be combined with other procedures, such as:

• pelvic osteotomy – a procedure used to reshape the hip socket in the pelvis
• straightening the femur if it is twisted.
   

Your child’s treatment team will let you know if any tests or scans need to be done and whether they need to see a physiotherapist or occupational therapist before the procedure

The hospital will call you before your child’s procedure to let you know:

• what time you need to arrive
• when your child needs to stop eating and drinking
• how long your child may need to stay in the hospital.

You may also want to tell:

• your child’s school of their surgery
• your workplace that you may need time off around the surgery
• friends and family who may be able to help out while your child is recovering.
   

Your child will be under a general anaesthetic for the procedure. This means they will be asleep and will not feel any pain. 

In the VDRO surgery:

1. the top of the femur is cut and tilted inwards, so it sits properly in the hip socket
2. the hip is then held in the new position with plates and screws.

Your child’s surgeon may also correct any other turning or twisting in the bone at the same time.

After the procedure, your child will be given pain medicine. In hospital, pain management is provided through either:

• a nerve block
• a drip
• oral medicine.

Your child’s doctor will let you know when they can go home from hospital. This will depend on: 

• their recovery 
• how strong the bone is 
• whether any other procedures were done at the same time.

Your child will have their leg held in place with a brace or plaster for around six weeks. This will keep the leg in the correct position and prevent pain.

Your child’s doctor will let you know when they can put weight on their leg after surgery. This could be between 6-8 weeks while the bone heals.