[Results of the follow-up of Ludloff open hip repositions and closed repositions in congenital hip dislocations].
Three combinations of therapy of CDH (closed and open reduction, with and without foregoing so called "functional" conservative treatment, and with and without retention in the frog position) have been evaluated among 82 children with 100 dislocated hips. They had been operated on 71 times by Ludloffs open reduction and 29 times by gentle closed reduction in anaesthesia. If following a test-x-ray in 130 degrees flexion of the hips and 50 degrees of abduction no spontaneous reduction occurs, an attempt at careful closed reduction under anaesthesia seems to be justified. If it is not successful with lack of a deep position of the head, an immediate open reduction after Ludloff with retention in hip flexion of about 130 degrees and slight abduction was in our hands less frequently followed by an avascular necrosis of the femoral head than following conservative treatment. The latter and the inhuman frog position are according to our statistics probably more responsible for the avascular necroses than the open reduction as such. Every treatment of CDH has to be evaluated in regard to the frequency of irreversible avascular necrosis of the femoral head.