Splintage in Developmental Dysplasia of the Hip: How Low Can We Go?

Sampath, J.; Deakin, S.; Paton, R. W.

doi:10.1097/01241398-200305000-00014

Cited by 28 publications

(32 citation statements)

References 15 publications

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“…Residual immaturity as measured by the AI was, however, demonstrated in more than one third of the patients. 31 Our results support observations made by Sampath et al 41 42 Neither of the 2 studies reported details of the final AIs; the researchers reported only that they were within the "normal range" for the children's age.…”

Section: Figuresupporting

confidence: 82%

Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns

Rosendahl

Dezateux²,

Fosse³

et al. 2010

Pediatrics

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OBJECTIVE: We conducted a blinded, randomized, controlled trial to examine whether mildly dysplastic but stable or instable hips would benefit from early treatment, as compared with watchful waiting. PATIENTS AND METHODS: A total of 128 newborns with mild hip dysplasia (sonographic inclination angle [α angle] of 43°–49°) and stable or instable but not dislocatable hips were randomly assigned to receive either 6 weeks of abduction treatment (immediate-treatment group) or follow-up alone (active-sonographic-surveillance group). The main outcome measurement was the acetabular inclination angle, measured by radiograph, at 1 year of age. RESULTS: Both groups included 64 newborns, and there was no loss to follow-up. With the exception of a small but statistically significant excess of girls in the active-sonographic-surveillance group, there were no statistically significant differences in baseline characteristics between the 2 groups. The mean inclination angle at 12 months was 24.2° for both groups (difference: 0.1 [95% confidence interval (CI): −0.8 to 0.9]), and all children had improved and were without treatment. The mean α angle was 59.7° in the treatment group and 57.1° in the active-surveillance group for a difference of 2.6° evaluated after 1.5 and 3 months (95% CI: 1.8 to 3.4; P < .001). At 1.5 months of age, the hips had improved in all treated children but not in 5 children under active surveillance (P = .06). Among the sonographic-surveillance group, 47% received treatment after the initial surveillance period of 1.5 months. CONCLUSIONS: Active-sonographic-surveillance halved the number of children requiring treatment, did not increase the duration of treatment, and yielded similar results at 1-year follow-up. Given a reported prevalence of 1.3% for mildly dysplastic but stable hips, a strategy of active surveillance would reduce the overall treatment rate by 0.6%. Our results may have important implications for families as well as for health care costs.

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Section: Figuresupporting

confidence: 82%

Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns

Rosendahl

Dezateux²,

Fosse³

et al. 2010

Pediatrics

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“…2 Similarly, by 2 to 4 weeks of age, Ͼ60% of infants identified at birth by abnormal clinical examination (Barlow or Ortolani tests) have reverted to normal when judged by repeat clinical examination or by ultrasound examination. 10,37,54 Longer prospective studies 28,[53][54][55][56][57][58][59] and a systematic review of observational studies of ultrasound screening 60 demonstrate that in untreated hips, mild dysplasia without frank instability usually (consistently Ͼ90%) resolves spontaneously between 6 weeks and 6 months.…”

Section: Key Question 3: What Is the Accuracy Of Screening Tests For mentioning

confidence: 99%

Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review for the US Preventive Services Task Force

Shipman¹,

et al. 2006

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“…The reason for this was that the pre-specified treatment protocol required that newborns with stable but mildly dysplastic hips as shown on ultrasound (1.3% of all newborns) were to be treated from birth. However more recent research suggests that active sonographic surveillance of this group reduces the number requiring treatment with similar results at follow-up (36,37).…”

Section: Sonographic Hip Phenotypes In An Unselected Newborn Populationmentioning

confidence: 89%

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Rosendahl¹,

Dezateux²

2009

Nor J Epidemiol

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During the last three decades technical advances and the introduction of new, radiation free modalities have allowed a less restrictive use of imaging. Combining different low-or no radiation modalities as appropriate affords a unique opportunity to undertake large-scale, population based longitudinal research examining the prevalence, natural history and the effectiveness of treatment for a variety of diseases. In this paper we address the use of imaging in epidemiological studies of developmental hip dysplasia (DDH) based on work performed at Haukeland University Hospital since 1987, and since 2006 in collaboration with MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London. This lifecourse approach to investigating phenotypes for, risk factors for, and outcomes of DDH is novel (1).

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Splintage in Developmental Dysplasia of the Hip: How Low Can We Go?

Cited by 28 publications

References 15 publications

Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns

Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns

Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review for the US Preventive Services Task Force

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