Avascular necrosis as a treatment complication in congenital dislocation of the hip in children under one year of age.

A retrospective review of 289 frank congenital dislocations of the hip in 241 patients seen and initially treated at less than one year of age was conducted to evaluate factors involved in the development of avascular necrosis. Premanipulation traction was found to be of significant benefit in reducing the incidence of avascular necrosis but not in eliminating it. It is suggested that the rigid plaster immobilization is the major causative agent in the residual cases of avascular necrosis. It is also apparent that the very young child, under three months of age, is even more susceptible.