The medial ludloff open reduction in developmental dysplasia of the hip before the age of walking

The medial open reduction of the developmentally dislocated hip was first described by Ludloff in 1908. It is now typically performed in infants younger than 12 months but has been reported in children up to 24 months of age. The approach most commonly used is between the femoral neurovascular bundle and the pectineus muscle. The advantages to the procedure include the direct approach to all blocks to reduction with minimal blood loss, the ability to perform surgery on bilateral hips during the same operation, and the cosmetic incision. The disadvantages include an increased risk of avascular necrosis, the inability to perform a capsulorrhaphy, and the technical expertise required to successfully navigate the approach. This synopsis reviews the technique for performing a medial open reduction and the recent literature regarding the outcomes.