A general consensus exists that hip dislocation in patient older than the age of 18 months should primarily be treated surgically . All of our patients have been treated conservatively with the modified method of Hoffmann Daimler with success. The highest reported success of operative treatment in this age group was 75% but also the rate of avascular necrosis of the femoral head was 20/40%

Late presented , neglected or failed to be treated successfully DDH cases are thought to be too old for management with any functional method, the modified Hoffman-Daimler method seem to achieve safe and lasting reduction with the lowest possible incidence of avascular necrosis and residual acetabular dysplasia (see clinical cases).