Open reduction for congenital hip dislocation: the risk of avascular necrosis with three different approaches.

A review of 49 hips with congenital dislocation that were treated with anterior open reduction after traction and arthrogram showed that partial avascular necrosis can occur even when adequate decompression of the femoral head is obtained. When femoral osteotomy is done in conjunction with open reduction, the rate of avascular necrosis is not greater than for open reduction alone. Open reduction combined with innominate osteotomy had the highest rate of partial avascular necrosis and also the highest rate of additional surgery required.