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Splintage for congenital dislocation of the hip. Is it safe and reliable?
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1987
Insights
This study evaluated splinting for unstable hips in infants, finding it generally safe but noting a 3.8% risk of vascular necrosis. Some infants still required later surgery despite early splint treatment.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Developmental Biology
Background:
- Infantile hip instability is a common condition requiring timely intervention.
- Early treatment aims to prevent long-term complications such as hip dysplasia.
- Splinting is a conservative management approach for unstable hips in infants.
Purpose of the Study:
- To assess the safety and reliability of a standardized splinting protocol for unstable hips.
- To evaluate the efficacy of the Von Rosen splint and the Pavlik harness in infants.
- To determine the incidence of complications associated with splint treatment.
Main Methods:
- A cohort of 215 children with 288 unstable hips were treated with splintage within the first nine months of life.
- A consistent treatment protocol involving the Von Rosen splint and/or Pavlik harness was applied.
- Outcomes including vascular necrosis and need for subsequent surgery were monitored.
Main Results:
- A 3.8% incidence of vascular necrosis was observed in the treated hips.
- The applied splinting protocol demonstrated a degree of safety and reliability.
- A subset of infants required surgical intervention despite initial splint treatment.
Conclusions:
- Conservative splinting is a viable initial treatment for infant hip instability.
- Vascular necrosis is a potential complication requiring careful monitoring.
- Further evaluation may be needed for cases requiring delayed surgical management.
Abstract:
Two-hundred and fifteen children with 288 unstable hips have been treated by splintage during the first nine months of life. A simple treatment protocol was followed and the aim was to test the safety and reliability of this protocol as well as of the Von Rosen splint and the Pavlik harness. A vascular necrosis occurred in 3.8% of the splinted hips. Despite splintage, a proportion of children needed operation at a later date.