The medial approach in congenital dislocation of the hip.

From January 1970 to January 1979, 50 hips in 39 patients were operated on for congenital dislocation of the hip at the University of Iowa. Each hip was evaluated for acetabular development, aseptic necrosis and subluxation; arthrograms were correlated with intraoperative findings. Aseptic necrosis occurred in two patients (5%). Intraarticular obstacles to reduction are described. Acetabular development progressed rapidly once concentric reduction was obtained. The medial approach provided a safe, effective way to reduce dislocated hips in infancy. We advocate this procedure when a concentric reduction cannot be obtained by closed manipulation or when the reduction is considered unstable.