1. Late presenters
2. Failures of splint in those < age 6/12
1. Adductor tenotomy + closed reduction
- most surgeons will attempt this initially
- risk of AVN wilth forceful reduction / excessive abduction
2. Open Reduction
- for failure of closed reduction
To obtain and maintain a concentric reduction without complication
0 - 6 /12
- best time for treatment
- maintain reduction of head & allow normal acetabular development
Obtain ultrasound
Graaf 2A and 2B
- Alpha angle 50 - 59o range
- many will resolve without treatment
THR in dysplastic hips has a higher failure rate
- due to anatomic abnormalities
- due to generally younger age
Restore normal biomechanics and preserve bone stock
Soft tissues