Even up until age 6-8 years, reduction is worthwhile. Click and subluxation followed with serial exam, many improve within one week. Bracing should be done by an orthopaedist familiar with pediatrics. The hip should reduce within three weeks, and there should be ultrasound or radiographic confirmation. Full time brace until hip is clinically stable, then part-time until radiographically normal.
Many surgeons proceed with a period of skin traction first to stretch the soft tissues.
After reduction, spica cast is applied for 3 to 6 months. The results of surgery decline the older the child is at reduction. Skin monitoring around casts and braces if important. Surgery Medial or lateral approach to the HIP joint to relieve the structures inside the joint blocking reduction. It may not be possible to fully reverse this process.