This is a 20 years retrospective review of 81 patients with 121 hips with developmental dysplasia of the hip treated by closed reduction, adductor myotomy and psoas tenotomy and immobilization in a spica cast, without prereduction traction. Divided in 2 groups, group 1: 93 hips from 7 to 18 months, and group II: 28 hips from 19 months to 3 years. The Bucholz-Ogden classification was used to determine the patterns of ischemic lesion and the final results were assessed according to Barret''s clinical criteria and Severin''s radiological rating. In group I (93 hips), 40 hips (43%) showed ischemic changes, mild (9 hips) to moderate (6 hips). The Barret clinical criteria showed 39 hips with excellent and good results and 1 hip fair. Severins radiological rating showed 37 hips in type l-II and 3 hips in type III. Group II (28 hips), 23 hips showed ischemic changes, mild in 5 hips, moderate 4 hips and severe in 3 hips. The Barret clinical criteria in the final assessment showed 19 hips with excellent-good results and 4 hips was fair. Severins radiological rating showed 21 hips in type I-II and 2 hips in type IV. Some of the patients needed additional surgical procedures. The ischemic changes were more severe as patients gets older.

This is a 20 years retrospective review of 81 patients with 121 hips with developmental dysplasia of the hip treated by closed reduction, adductor myotomy and psoas tenotomy and immobilization in a spica cast, without prereduction traction. Divided in 2 groups, group 1: 93 hips from 7 to 18 months, and group II: 28 hips from 19 months to 3 years. The Bucholz-Ogden classification was used to determine the patterns of ischemic lesion and the final results were assessed according to Barret''s clinical criteria and Severin''s radiological rating. In group I (93 hips), 40 hips (43%) showed ischemic changes, mild (9 hips) to moderate (6 hips). The Barret clinical criteria showed 39 hips with excellent and good results and 1 hip fair. Severins radiological rating showed 37 hips in type l-II and 3 hips in type III. Group II (28 hips), 23 hips showed ischemic changes, mild in 5 hips, moderate 4 hips and severe in 3 hips. The Barret clinical criteria in the final assessment showed 19 hips with excellent-good results and 4 hips was fair. Severins radiological rating showed 21 hips in type I-II and 2 hips in type IV. Some of the patients needed additional surgical procedures. The ischemic changes were more severe as patients gets older.