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The effect of functional splinting on mild dysplastic hips after walking onset
Henning Windhagen1, Fritz Thorey, Heinrich Kronewid
1Department of Orthopaedic Surgery, Hannover Medical School, Annastift, Anna-von-Borries-Str.1, 30625 Hannover, Germany. windhagen@annastift.de
Background:
For treatment of Graf class IIb dysplastic hips at walking onset a treatment concept with abduction splints allowing patterns as walking and crawling under constant abduction control was investigated. However, as the splint still incapacitates child movements the research question remains whether the physiologically progressing maturation of hips can be significantly altered using such abduction splints for walking children.
Methods:
Of 106 children showing late hip dysplasia, 68 children treated with the Hoffman-Daimler (HD-splint) abduction splint were compared with 38 children with neglect of the abduction treatment in this retrospective study. Radiographic analyses were performed measuring the development of the age dependent acetabular angle.
Results:
The regression analysis for splint treatment showed a significant linear regression for both splint treatment and no splint treatment group (r2 = 0.31 respectively r2 = 0.33). No statistical difference between both treatment groups was apparent.
Conclusion:
Considering the characteristics of this study, there seems to be no strong rationale supporting the use of an abduction device in growing children. As no significant difference between treatment groups is apparent, a future controlled prospective study on splinting effects can be considered ethically allowed.