Technique for open reduction, primary femoral shortening, and Salter osteotomy. A, Femoral head is dislocated. Gluteal muscles (a) are retracted and slightly shortened. Iliopsoas muscle (b) is intact. Capsule is interposed between femoral head and ilium. Segment of femur is resected. B, Proximal femur is abducted; iliopsoas tendon (b) is divided if needed to mobilize the proximal fragment. Capsule is incised on inferior surface parallel to femoral neck. C, Operation is complete. Gluteal muscles (a) are tight. Salter osteotomy is completed with graft in place. Femoral fragments are fixed with pediatric hip screw. SEE TECHNIQUE 30.7.