LONG TERM OUTCOME OF CLOSED REDUCTION OF THE INFANT HIP: ARE SOFT TISSUE RELEASE AND LENGTH OF POSTOPERATIVE IMMOBILISATION IMPORTANT FACTORS?

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PurposeTo investigate the effect of soft tissue release (STR) and the length of postoperative immobilisation on the long term outcomes of closed reduction (CR) of the hip for developmental dysplasia of the hip.Materials77 hips (72 patients) who had undergone closed reduction (CR) between 1977-2005 were studied retrospectively to review their outcome (Severin grade), identify the reasons for failure and to assess factors associated with residual dysplasia. Particular attention was paid to the use of a STR at the time of CR (to improve initial hip stability) and the duration of postoperative immobilisation.ResultsThe mean age at CR was 10.5 months (5-24months) and mean follow up 97 months. A STR (adductor ± psoas tenotomies) was performed in 65%. Post-operative immobilisation time varied between 3-12 months (mean 6.3 months).6 hips (all Tonnis grade 3) failed CR within 2-6 weeks. In the remaining 49 hips, 85% were Severin Grade 1 at age 5yrs. Acetabular index (AI) decreased in all patients over time: 80% hi...

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