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Tübingen hip flexion splints for developmental dysplasia of the hip in infants aged 0-6 months
You Zhou1, Rong Li2, Chuan Li3
1Department of Orthopedics, Kunming Children's Hospital, 288 Qianxing Road, Xishan District, Kunming, 650034, Yunnan, China.
Insights
The Tübingen hip flexion splint effectively treats developmental dysplasia of the hip (DDH) in infants, with success rates of 83.7%. Key risk factors for treatment failure include late initiation, family history, severe hip dysplasia, and bilateral involvement.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Biomedical Engineering
Background:
- Developmental dysplasia of the hip (DDH) is a prevalent infant condition.
- Early intervention is crucial for successful DDH management.
Purpose of the Study:
- To assess the efficacy and safety of Tübingen hip flexion splints for infant DDH.
- To identify risk factors associated with treatment failure in DDH.
Main Methods:
- Retrospective analysis of 259 hips in 195 infants (Graf type IIc or worse).
- Follow-up for at least 6 months, with avascular necrosis diagnosis via radiographs.
- Successful treatment defined by Graf type I or International Hip Dysplasia Institute type I classification.
Main Results:
- 83.7% of patients achieved successful treatment outcomes.
- Avascular necrosis occurred in 3 hips (1.15%).
- Independent risk factors for failure: late treatment initiation (>12 weeks), family history, Graf type IV, and bilateral DDH.
Conclusions:
- Tübingen splints demonstrate good efficacy and safety for treating infant DDH (0-6 months).
- Early treatment initiation (before 12 weeks) is critical for optimal outcomes.
- Specific patient factors (family history, severity, bilaterality) predict treatment success.
Background:
Developmental dysplasia of the hip (DDH) is a common disorder in infants. The present study aimed to evaluate the efficacy and safety of the Tübingen hip flexion splints in treating DDH in infants aged 0-6 months.
Methods:
This is a retrospective study analyzing 259 hips in 195 infants with DDH of Graf type IIc or worse classifications treated between January 2015 and December 2017. Patients were followed up for at least 6 months. Avascular necrosis of the femoral head was diagnosed using plain radiographs at the last follow-up visit according to the Bucholz-Ogden classification. Successful treatment was defined as an improvement of the Graft classification to type I, or an improvement of the International Hip Dysplasia Institute classification to type I in patients aged > 6 months.
Results:
Treatment was deemed successful in 128 patients (83.7%). Avascular necrosis occurred in 3 patients (3 hips). Univariate analysis showed that late treatment initiation, family history of DDH, Graf type IV and bilateral involvement were independent risk factors for treatment failure (p < 0.05). The receiver operating characteristic curve showed a cut-off value of 12 weeks for age at treatment initiation regarding successful treatment. Logistic regression analysis showed that gender, breech presentation, firstborn, swaddling, birth weight > 3.5 kg, oligohydramnios, foot deformity and torticollis did not affect the success rate of treatment (p > 0.05).
Conclusions:
The Tübingen splint showed good efficacy and safety in treating DDH in infants aged 0-6 months. Family history of DDH, Graf classification of type IV, bilateral involvement and treatment initiation after 12 weeks of age are risk factors of treatment failure.
Trial Registration:
N/A.
