6 weeks with the von Rosen splint is sufficient for treatment of neonatal hip instability

Abstract

Background There is no concensus on the optimal treatment time for unstable hips in the newborn. We analyzed the efficiency of a treatment program that has been used for 10 years at our hospital, in which all unstable hips (subluxatable, Barlow-positive and Ortolani-positive) are treated with the von Rosen splint for 6 weeks.Patients and methods Between 1988 and 1997, 32,171 children were born alive at the hospital. During this period 247 children had a clinically unstable hip diagnosed. 223 of the 247 children underwent a radiographic follow-up after 5-15 years.Results 1 patient with bilateral instability and treated with a splint for 6 weeks showed a dislocated left hip at the radiographic examination at 8 months, which is part of the screening program, and needed operative treatment. 1 patient did not follow the treatment program and showed a dislocated hip at the age of 3. Another 4 patients required more treatment than the 6 weeks with the splint.We found no dysplastic hips at the radiographic follow-up. There was no late dysplasia and there were no late dislocations in children born in Lund between 1988 and 1997 who were diagnosed at other Swedish centers that treat developmental dysplasia of the hip (DDH).Interpretation We conclude that the present screening and 6-week treatment in a von Rosen splint prevent almost all cases of late dysplasia and late dislocation of the hip.

The success of management with the Pavlik harness for developmental dysplasia of the hip using a United Kingdom screening programme and ultrasound-guided supervision

“…2,14,15 However, other devices, such as the von Rosen splint, have also been shown to be successful. 16,17 It has been suggested that the more rigid splintage offered by the von Rosen splint may be more successful than the Pavlik harness in the management of severe DDH, but so far no formal randomised controlled trial has been conducted.…”

Evidence-based Management of Developmental Dysplasia of the Hip

“…[34][35][36][37][38][39] These outcome measures have limitations: the study groups were heterogenous, timing of treatment varied, and the presence of AVN was not routinely recorded.…”

0–6 ay çocuklarda gelişimsel kalça displazisi (GKD) tedavisi

“…[22][23][24][25][26][27][28] GKD tedavisinde daha az sıklıkla kullanılan Rosen ateli ile ilgili yapılan çalışmalar ise Tablo 2'de özetlenmiştir. [29][30][31][32][33][34] Literatürde Pavlik bandajını diğer tedavi metodlarıyla da karşılaştıran çalışmalar da yapılmıştır. Atar ve arkadaşları, randomize olmayan olgu serilerinde radyolojik görünüm ve sekonder tedavi oranları açısından daha başarılı bulmuşlardır.…”