DDH 24+ Months

DDH >24 months
Approach to DDH – 24 Months and Older

– this is where you have to start thinking about osteotomies of the pelvis and acetabulum

– definitely need open reduction here – abandon thoughts of closed reduction, because the femur is up too high and even by some act of God you got it down into the crappy little acetabulum and managed to keep it there, you�d be putting the head at high risk of AVN.

– the basic approach here is:
– Salter osteotomy
– open reduction
– femoral shortening varus derotation osteotomy

Note: give up on a unilateral dislocation after age 8; give up on the bilateral dislocation at age 6