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[An ultrasound hip screening program--middle term results of flexion-abduction orthosis therapy]
H Mittelmeier1, D Deimel, B Beger
1Orthopädische Universitätsklinik und Poliklinik Homburg/Saar.
Insights
Early detection and treatment of developmental dysplasia of the hip (DDH) using ultrasound and abduction pants in newborns likely leads to normal hip development. This approach shows positive mid-term outcomes in children.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
Background:
- Hip sonography is a standard method for detecting congenital hip maturation disturbances in newborns.
- Short-term studies indicate that flexion-abduction bandages can achieve mature hip joints within months.
Purpose of the Study:
- To evaluate the mid-term outcomes of developmental dysplasia of the hip (DDH) treated in infancy.
- To assess the long-term efficacy of early ultrasound screening and abduction pant treatment for hip dysplasia.
Main Methods:
- Prospective study of 57 dysplastic hips in 42 children, followed up for an average of 7.8 years.
- Children underwent ultrasonic hip screening and were treated with abduction pants for Graf types IIg, D, and III hip dysplasia.
Main Results:
- Only 5% of cases showed slight clinical motion limitations (Tönnis classification).
- Radiographic evaluation revealed an average AC-angle of 11°, CE-angle of 28°, and Tönnis hip-score of 8.5.
- Minor radiological deviations were noted in 9% of cases; no severe pathologies or avascular necrosis were observed.
Conclusions:
- Early detection of DDH on the first day of life followed by immediate treatment with abduction pants promotes probable physiological hip development.
- Mid-term follow-up suggests successful management of infantile hip dysplasia with non-invasive methods.
Introduction:
Today the hip sonography is an established method to detect congenital hip maturation disturbances in the first days of life. Short-term follow-ups have showed that mature hip joints can be performed with an flexion-abduction bandage within a few months.
Methods:
This prospective study reviews in a middle-term follow up 57 dysplastic hips at birth of 42 children after an average period of 7.8 years, who took part in an ultrasonic hip screening and were treated successfully with an abduction pant (33 hips type IIg, 16 hips type D, 8 hips type III according to Graf).
Results:
There were only 3 cases (5%) who had slight limitations of motion clinically according to the classification of Tönnis. The radiographic control showed an average AC-angle of 11 degree, an average CE-angle of 28 degree and an average hip-score according to Tönnis of 8.5. Slight radiological deviations were found in 9% of the cases. Severe pathologic radiographic appearance or avascular necrosis of the femoral head were not observed.
Conclusions:
If DDH is detected in first day of life and immediately treated with abduction pants is physiological development of the hip probably.