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The von Rosen splint compared with the Frejka pillow. A study of 408 neonatally unstable hips
1Department of Orthopedics, University Hospital, Tromsö, Norway.
Insights
The Frejka pillow and von Rosen splint showed similar outcomes for treating neonatal hip instability. However, the Frejka pillow group had more cases requiring further treatment for hip dysplasia.
Area of Science:
- Pediatric Orthopedics
- Developmental Dysplasia of the Hip
Background:
- Neonatal hip instability (NHI) requires effective treatment to prevent long-term complications.
- The Frejka pillow and von Rosen splint are common orthotic devices used for NHI management.
- Comparative studies are essential to determine the optimal treatment strategy for NHI.
Observation:
- A study compared 101 children treated with the Frejka pillow (4.5 months) in Norway to 307 children treated with the von Rosen splint (3 months) in Sweden.
- Pelvic radiographs were assessed using the acetabular index (AI) at the end of treatment.
- Failure cases were evaluated based on remaining acetabular dysplasia and/or subluxation.
Findings:
- The acetabular index (AI) showed no significant difference between the Frejka pillow and von Rosen splint groups.
- Four patients in the Frejka pillow group required further treatment for residual acetabular dysplasia or subluxation.
- No patients in the von Rosen splint group required further treatment, though differing failure criteria may influence this observation.
Implications:
- While both orthotic devices appear comparable in improving acetabular index, the Frejka pillow may be associated with a higher rate of residual hip instability.
- Further research with standardized failure criteria is needed to definitively compare the long-term efficacy of these treatments for neonatal hip instability.
- Clinical decision-making regarding NHI treatment should consider the potential need for subsequent interventions based on the chosen orthotic device.
Abstract:
101 children in Tromsö, Norway, treated with the Frejka pillow for 4.5 months because of neonatal hip instability (NHI) were compared with 307 children in Malmö, Sweden, treated with the von Rosen splint for 3 months. The pelvic radiographs, taken when the treatment was terminated, were assessed by the acetabular index (AI) and the cases of failure were evaluated. The AI showed no difference between the two groups. The Frejka group had 4 patients who received further treatment because of remaining acetabular dysplasia and/or subluxation while the von Rosen group had none. The difference in risk of failure might partly be explained by different criteria for failure.