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Complications of splintage in congenital dislocation of the hip
V G Langkamer1, N M Clarke, P Witherow
1Department of Orthopaedic Surgery, Bristol Children's Hospital.
Insights
Abduction splintage for congenital hip dislocation can cause serious complications. Careful patient selection and expert monitoring are crucial to minimize risks like avascular necrosis and pressure sores.
Area of Science:
- Pediatric Orthopedics
- Skeletal Dysplasias and Deformities
Background:
- Congenital dislocation of the hip (CDH) is a common pediatric orthopedic condition.
- Abduction splintage is a widely used treatment modality for CDH.
Observation:
- This paper reports on six children who experienced complications from abduction splintage.
- Complications included avascular necrosis of the femoral head, pressure sores, and excessive tibial torsion.
Findings:
- Sustained splintage of an unreduced hip can lead to adverse outcomes.
- Overcorrection of femoral head displacement is a potential risk.
- Avascular necrosis of the femoral head is a significant complication.
Implications:
- Expert supervision is essential for safe and effective abduction splintage.
- Judicious case selection and regular patient review are critical.
- Minimizing complications requires careful management and monitoring during treatment.
Abstract:
The use of abduction splintage in the treatment of congenital dislocation of the hip has an important morbidity. Six children who developed complications are presented in this paper. Sustained splintage of an unreduced hip, overcorrection of the femoral head displacement, avascular necrosis of the femoral head, full thickness pressure sores, and excessive tibial torsion may occur as a consequence of treatment. Expert supervision of abduction splintage, correct case selection, and regular review are necessary to reduce the incidence of such complications.