PRELIMINARY-RESULTS OF EARLY OPEN REDUCTION BY AN ANTERIOR APPROACH FOR CONGENITAL DISLOCATION OF THE HIP

We report the results of 113 early open reductions of congenitally dis located hips using a technique we have developed. Surgery is followed by functional postoperative treatment with a Pavlik harness or abducti on splint. The age of the patients and the follow-up period ranged fro m 6 to 24 months and 2 to 12 years, respectively. Radiologic results c orresponded to Severin grades I and II in 98%. Severe ischemic necrosi s was not observed. Secondary surgery (femoral derotation osteotomy an d/or Pemberton's operation) was performed in 21% of the cases. Reducti on at a young age resulted in fewer secondary procedures. Good results were attributed to postoperative treatment: Abandoning rigid fixation prevented soft tissue stretching, which may endanger blood supply to the joint. This treatment ensures concentric reduction and allows earl y and spontaneous joint mobilization in a functional position. These f actors stimulate further joint development.