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Fifty-six developmentally dislocated hips occurring in 37 children with an average age of 11.2 months (range, 2-25) underwent medial open reduction without preliminary traction by Ferguson's approach. Follow-up averaged 8.1 years (range, 3-17). Ninety-eight percent of hips were rated either excellent or good at final follow-up (Severin I or II). Eleven (19%) hips required secondary bony reconstructive procedures. Five (8.9%) hips demonstrated evidence of avascular necrosis. The authors conclude that medial open reduction is a safe and effective surgical treatment for developmental dislocation of the hip in the child younger than 2 years.