CLOSED REDUCTION OF DEVELOPMENTAL DISLOCATION OF THE HIP IN CHILDREN OLDER THAN 18 MONTHS

Thirty-eight hips in 32 patients greater than or equal to 18 months of age had closed reduction attempted for developmental dislocation of t he hip. Twenty-six hips in 24 patients had an initially successful clo sed reduction. During cast treat ment three of 26 hips had progressive subluxation or dislocation requiring open reduction with or without c oncomitant osteotomies. The remaining 23 hips, with an average follow- up of 8 + 8 years, are thought to have had a successful closed reducti on. Eleven of those hips have required no further surgical procedures and had an average acetabular index of 18 degrees at last follow-up. T welve of the 23 hips that had successful closed reduction required a f emoral or pelvic osteotomy for failure to remodel. Younger age (<22 mo nths) at the time of reduction and lower grade (I and II) dislocation were favorable prognostic indicators of the likelihood of successful c losed reduction.