[The Ludloff-Ferguson approach for congenital hip dislocation in children ages 2-4 years]

The objective of this study is to show that the Ludloff-Ferguson approach is feasible in patients aged 2-4 years and as an outpatient procedure.

Prospective, longitudinal, clinical-trial type of study, conducted from January 2008 to December 2009. Patients aged 2-4 years with a diagnosis of congenital hip dislocation were included. All of them underwent open reduction using the Ludloff-Ferguson approach as an outpatient procedure and they wore a Callot type of cast for 6 weeks. Bilateral hips were treated in a single stage. The study variables included the age, sex, operative time, bleeding, anesthetic time, infections and avascular necrosis of the femoral head. A nonrandomized, non-probabilistic sampling was performed; the statistical analysis included the central trend and scatter measurements, the relative risk, the Spearman correlation and chi2.

Fifteen patients were included, 8 females and 7 males, for a total of 21 hips. The latter included 4 left and 3 right hips, and 7 cases were bilateral. Median age was 3 years (range 2-4 years). The mean bleeding was 20 cc with a SD of 5 cc (range: 15-30 cc). The mean operative time was 25 minutes, SD = 7 minutes (range: 17-30 minutes). The chi2 test rejected the Ho for sex and necrosis, and age and avascular necrosis, with a P = 0.005. The results of the Spearman test for sex and necrosis were r = 0.23, P = 0.002, for age and necrosis r = 0.25, and a P = 0.003, for the operative time and avascular hip necrosis r = 0.28, P = 001. There were no infections.

The open reduction technique with the Ludloff-Ferguson approach is feasible in patients aged 2-4 years as an outpatient procedure, and the risk of avascular necrosis was minimum.