A COMPARATIVE-STUDY OF NONOPERATIVE VERSUS OPERATIVE TREATMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP IN PATIENTS OF WALKING AGE

We retrospectively reviewed our results of treatment of two groups of children with developmental dysplasia of the hip (DDH) aged between 13 and 17 months. The-nonoperative group consisted of 16 patients (17 hi ps) who were treated by closed reduction and casting with or without s kin traction. There were four hips with mild degrees of avascular necr osis, and one hip with a failed reduction. Before further treatment, t here were one hip in Severin class I, nine in class III, six in class IV, and one in class VI. Subsequent open reduction or pelvic osteotomy was required in those hips with failed reduction and residual dysplas ia. The operative group consisted of 32 patients (32 hips). Open reduc tion and Salter osteotomy were performed without preoperative traction . There was one hip with redislocation due to improper use of a short spica and two hips with a mild degree of avascular necrosis. In >2 yea rs and 3 months of follow-up, 13 hips were in Severin class I, 18 in c lass II, and one in class III. The treatment time was significantly sh ortened in the operative group. We conclude that neglected DDH in pati ents of walking age can be safely and effectively treated by open redu ction plus Salter osteotomy.