Open reduction of developmental hip dysplasia using a medial approach: a review of 24 hips

The results of the Ferguson medial approach for reduction of developmental hip dysplasia were reviewed for 24 hips. The mean age at surgery was 4.8 months and the mean length of clinical follow-up was 59 months. Clinically all hips were normal in follow-up and radiologically the acetabular index was within normal limits. There was the need for further surgery in two cases with loss of concentric reduction. There were two cases showing evidence of vascular insult post operatively according to the classification of Kalmachi and MacEwan. We conclude that the Ferguson medial approach is a safe and effective form of treatment for open reduction of developmental hip dysplasia in cases where closed reduction either has failed or is inappropriate. The age of the child or the presence of the upper femoral ossific nucleus does not appear to affect outcome. The procedure can safely be performed before six months of age.