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Introduction: Developmental dysplasia of hip (DDH) is an abnormal development of hip joint which when neglected in early age group can lead to joint pain and secondary osteoarthritic changes. Crowe types III and IV neglected DDH joint is widely managed with total hip arthroplasty with subtrochanteric shortening., Case Report: A 52-year-old female presented with neglected DDH joint which was managed in two stages with femoral lowering followed by uncemented total hip arthroplasty without osteotomy., Conclusion: With the two-stage procedure, subtrochanteric shortening which is widely accepted management for neglected DDH and the related complications were avoidable with a satisfactory Harris hip score., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Introduction: It is very common for pediatric orthopedic surgeon to encounter developmental dysplasia of hip (DDH) in walking age, especially in developing countries. The conservative options of management are almost over by this age and most require open reduction (OR) with various adjunct procedures. The most preferred approach for OR in this age group is anterior Smith-Peterson approach to hip joint. These neglected cases also require femoral shortening ± derotation osteotomy and acetabuloplasty., Case Report: In this surgical video technique, we demonstrate OR + femoral shortening and derotation osteotomy and acetabuloplasty, step by step, in a neglected, walking age DDH in a 3-year-old child. We hope that the detailed demonstration and tricks at various surgical steps will benefit our readers and viewers., Conclusion: Step-wise surgical execution as per demonstrated technique makes the procedure easily reproducible with fairly good outcomes. In this case example, with demonstrated surgical technique, we were able to achieve a good outcome at short-term follow-up., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)