Open reduction of DDH is indicated in late presenting cases and those who fail Pavlik Harness treatment, if closed reduction is unsuccessful. Recognised techniques involve excision of the ligamentum teres to allow maximal medialisation of the femoral head into the acetabulum. We describe a new technique in which the ligament’s femoral attachment is preserved and the medial end is passed through the incised transverse ligament. Gentle traction on the medial end is used to aid reduction and when sutured to the anterior capsule, the reduction is stabilised. We present our operative experience and early follow up of 8 cases.
We describe a patient with cerebral palsy, of normal intelligence, who could not walk but who by the age of 16 had been successfully managed with a staged bilateral total hip arthroplasty using a constrained liner.