Closed reduction of congenital dislocation of the hip: prediction factors and results

From 2009 to 2015, 15 infants with a congenital dislocation of the hip were treated with closed reduction under anaesthesia, after first being treated with Pavlik bandaging. A retrospective study was carried out with a minimum follow-up of 1 year to assess the success rate of the procedure and predictive factors. Twelve out of 15 (80%) patients achieved successful reduction. In the successful cases, the Barlow test was positive and the safe zone was 20 degrees or more. In the unsuccessful cases, there was a negative Barlow present in the outpatient clinic and the safe zone was less than 20 degrees. These three cases all had teratologic comorbidity, and required additional surgery in the form of open reduction. Avascular necrosis was noted in one out of 15 (6.7%) patients. In nonteratologic hips, a positive Barlow test with a safe zone of 20 degrees is predictive of a successful closed reduction. In these patients, anaesthesia and arthrography might not be necessary. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.