MEDIAL APPROACH OPEN REDUCTION WITHOUT PRELIMINARY TRACTION FOR CONGENITAL DISLOCATION OF THE HIP

We examined the results of medial approach open reduction without prel iminary traction or attempt at closed reduction for congenital disloca tion of the hip (CDH) in children aged <1 year prospectively. In all c hildren, a trial of conservative treatment with Pavlik harness failed. Twenty-three hips in 19 children were treated. Follow-up ranged from 5 to 10 years (average 8 years). None of the hips redislocated. Osteon ecrosis of the femoral head occurred in one patient with coxa magna. T wo children subsequently underwent Salter innominate osteotomy for hip dysplasia. Early detection and treatment with Pavlik harness is our p referred approach to treatment of CDH. In children who have failed ini tial harness management, medial approach open reduction without prelim inary traction affords a safe, effective, and relatively simple altern ative to other methods of treatment.