Closed reduction of congenital dislocation of the hip: prediction factors and results.

Abstract

From 2009 to 2015, 15 infants with a congenital dislocation of the hip were treated with closed reduction under anaesthesia, after first being treated with Pavlik bandaging. A retrospective study was carried out with a minimum follow-up of 1 year to assess the success rate of the procedure and predictive factors. Twelve out of 15 (80%) patients achieved successful reduction. In the successful cases, the Barlow test was positive and the safe zone was 20° or more. In the unsuccessful cases, there was a negative Barlow present in the outpatient clinic and the safe zone was less than 20°. These three cases all had teratologic comorbidity, and required additional surgery in the form of open reduction. Avascular necrosis was noted in one out of 15 (6.7%) patients. In nonteratologic hips, a positive Barlow test with a safe zone of 20° is predictive of a successful closed reduction. In these patients, anaesthesia and arthrography might not be necessary.