Related Experiment Videos
Splintage in developmental dysplasia of the hip: how low can we go?
Jayanth S Sampath1, Susan Deakin, Robin W Paton
1Blackburn Royal Infirmary, Blackburn, U.K. jsampath@nemours.org
Insights
Reducing splinting for developmental dysplasia of the hip (DDH) is possible. This study shows lower splintage rates in infants did not negatively impact DDH treatment outcomes.
Area of Science:
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip (DDH) Management
Background:
- Indications for abduction splinting in developmental dysplasia of the hip (DDH) lack clear definition.
- Current practices may lead to over-splinting in infants.
Purpose of the Study:
- To evaluate the impact of modified splinting protocols on DDH treatment outcomes.
- To determine if reduced splintage rates affect surgical intervention rates for DDH.
Main Methods:
- Prospective evaluation of 797 infants using targeted ultrasound screening.
- Comparison of two groups: early splinting (Pavlik harness) vs. delayed splinting for persistent instability.
- Standardized splinting criteria at 9 weeks for persistent major dysplasia.
Main Results:
- Splintage rates decreased from 1.6/1,000 live births (1996-97) to 0.8/1,000 live births (1998).
- The overall average splintage rate was 1.3/1,000 live births.
- No increase in the rate of surgery for DDH was observed despite reduced splinting.
Conclusions:
- A lower splintage rate for DDH is achievable without compromising treatment efficacy.
- Optimized screening and treatment protocols can reduce unnecessary interventions in infants with DDH.
Abstract:
The indications for using abduction splints in developmental dysplasia of the hip (DDH) are not clearly defined. In this study, the authors prospectively evaluated 797 babies born between 1996 and 1998 as part of a limited targeted ultrasound screening program. In the first group (1996-97), babies with clinical hip instability at first scan were placed in a Pavlik harness. In the second group (1998), only babies who had persistent instability at 2 weeks were splinted. Children with persistent major dysplasia at 9 weeks were splinted in both groups. The splintage rate was 1.6/1,000 live births in the first group and 0.8/1,000 live births in the second group. The rate of surgery for DDH did not increase despite a significant decrease in the number of babies being splinted. This study demonstrates that a splintage rate as low as 1.3/1,000 live births (average rate for 1996-98) can be achieved without adversely affecting the outcomes following treatment of DDH.