Although older children and high dislocations may be more likely to require a femoral
shortening osteotomy, the ultimate decision about whether or not to shorten a given femur
should depend on the ease of femoral head reduction in that specific patient. Adding a
femoral shortening procedure increases operating time and blood loss, adds a second incision,
and necessitates future hardware removal. In addition, an unnecessary femoral shortening
osteotomy could overly decrease the soft tissue tension around the joint, putting the hip at
risk for redislocation. This study was designed to explore an algorithm based on strict age
and radiographic criteria that identify those without the need of femoral osteotomy.