Comparison of Open and Closed Reduction for Developmental Dysplasia of the Hip: A Retrospective Evaluation of Acetabular Development and Complications

Background/Objectives: Developmental dysplasia of the hip (DDH) is a common pediatric musculoskeletal disorder, and the optimal treatment approach remains controversial. This study compared open and closed reduction in terms of acetabular development, avascular necrosis (AVN) of the femoral head, and the need for subsequent pelvic osteotomy.

Methods

This retrospective cohort study evaluated 75 patients (95 hips; 48 right, 47 left) treated for DDH at a tertiary referral center. We performed open reduction in 63 hips and closed reduction in 32. We performed arthrography in 50 hips (52.6%) with a positive Ortolani test to assess reduction quality. We assessed acetabular remodeling using the acetabular index (AI) at 6, 12, and 36 months postoperatively. Dislocation severity was graded using the Tönnis classification, and AVN was assessed using the Kalamchi–MacEwen criteria. Statistical analyses included chi-square tests, independent-samples t-tests, one-way ANOVAs, and Pearson correlation tests, with significance set at p < 0.05.