From January 1970 to December 1976, seventeen patients with twenty-two
congenital hip dislocations were treated by open reduction through a medial
approach. The average follow-up was 42.2 months. The patients were
evaluated for acetabular development, aseptic necrosis, and intraoperative
findings. The incidence of aseptic necrosis was 10 per cent. The acetabular
index improved rapidly during the first year after reduction. After the
first year the rate of development was decreased, but the acetabular index
continued to improve throughout the period of study. The medial approach
provides a safe, effective way to reduce a dislocated hip in infancy. This
procedure is advocated when closed reduction cannot be obtained by gentle
manipulation or maintained by positioning once reduction is done.