Acetabular development after closed reduction of developmental dislocation of the hip

The purpose of this study was to identify predictive factors that would best indicate possible future acetabular dysplasia after closed reduction of developmental dysplasia of the hip (DDH). We studied 32 hips for a mean of 13.5 years, during which time radiographs were analyzed annually. Overall results were evaluated using the modified Severin classification. Using the combined predictive factors of center-head distance discrepancy (CHDD) and sourcil orientation in patients between 4 and 5 years of age, we found that (a) remodeling of the acetabulum was possible when the CHDD was < 6% and the orientation of the sourcil was horizontal; (b) careful follow-up was needed when the CHDD was < 6% and the sourcil was upward or when the CHDD was > or = 6% and the sourcil was horizontal, (c) surgery was recommended to prevent residual acetabular dysplasia when the CHDD was > or = 6% and the sourcil was upward.