Evidence based treatment for developmental dysplasia of the hip in children under 6 months of age. Systematic review and exploratory analysis

Tübingen hip flexion splint for the treatment of developmental dysplasia of the hip in children younger than six months age: A meta-analysis

“…To reduce the incidence of complications, Pavone et al 21 suggested a close follow-up by US, while Kubo et al 20 suggested regular radiographic assessment of acetabular development, as per the Tönnis classification, until skeletal maturity. Ashoor et al 37 evaluated the outcomes across six studies using the THFS (713 children; 1001 hips), reporting a pooled failure rate of 7.79% (0% to 25%), AVN rate of 0.5% (0% to 2.4%) and residual dysplasia rate of 6.7%. 13 , 19 - 21 , 23 , 25 , 38 However, they did not stratify the results according to the Graf subtype.…”

“… 13 , 19 - 21 , 23 , 25 , 38 However, they did not stratify the results according to the Graf subtype. 37 Failure of the PH is commonly reported in patients with high or fixed dislocation and subsequent AVN. According to Tiruveedhula et al, 34 if the hip reduction is not achieved within six weeks, PH treatment should be abandoned and surgical options such as open/closed reduction should be considered.…”

Principles of Bracing in the Early Management of Developmental Dysplasia of the Hip

“…Brace selection is influenced by the size of the infant, severity of dysplasia, physician preference, local availability and affordability. It is difficult to compare braces and define successful outcomes due to heterogeneity in patient selection and lack of consensus on treatment indications [3,13]. The simplest form of bracing is double diapering which has not been shown to be useful maintaining hip reduction [14].…”

“…Pavone et al [22] defined their primary outcome measure as "regression of dysplasia". Ashoor et al [13] used the crude failure rate as their primary outcome measure. Both studies provided evidence comparing the efficacy of different braces.…”

“…Table 1 Fig. 1 Commonly used DDH braces describes the pooled outcomes in terms of success and failure represented in the two systematic reviews [3,13].…”