Treatment results of patients with developmental dysplasia of the hip, who were treated with tubingen hip flexion splint

Year 2023, Volume: 40 Issue: 3, 594 - 598, 30.09.2023

İsmail Büyükceran , Hikmet Çinka , Alparslan Yurtbay , Hüseyin Sina Coşkun , Alper Çıraklı , Emrah Sayıt , Davut Keskin

Abstract

Developmental dysplasia of the hip (DDH) can be treated successfully with early diagnosis and conservative methods. In this study, we evaluated the results of patients with DDH who were treated with Tubingen hip flexion splint (THFS). The results of patients with DDH who were treated with a Tubingen hip flexion splint (THFS) were retrospectively evaluated. 75 hips of 50 patients were evaluated in the study. According to the Tönnis Stage system, 49 of the hips were dysplasia, 18 of the hips were subluxations, and 8 of the hips were dislocations. The mean age at the time of starting the THFS was 3.48 (1.5-5.5) months, and the duration of treatment was 5.5 (3-9) months. Ultrasonographically normal hip (Graf type 1) and/or sufficient acetabular index values with concentric hip reduction and hips without avascular necrosis of the femoral head were considered successful results. Treatment of four patients in this study failed. 3 of these patients were female. 3 of the failed patients had left hip dysplasia, and one had right hip dysplasia. There was no significant relation between hip side and treatment success (p = 0.638). None of the patients had avascular necrosis. The overall success rate was 92%. As a result of this study, we observed that THFS is an effective treatment option for DDH treatment.

Keywords

Developmental dysplasia of the hip, treatment, Tubingen splint, Graf

References

• 1. Bialik V, Bialik GM, Blazer S, Sujov P, Wiener F, Berant M. Developmental dysplasia of the hip: a new approach to incidence. Pediatrics. 1999;103(1):93-9.
• 2. Lyu X, Chen T, Yang Z, Fu G, Feng C, Zhang T, et al. Tübingen hip flexion splint more successful than Pavlik harness for decentred hips after the age of three months. The Bone & Joint Journal. 2021;103(5):991-8.
• 3. Atalar H, Gunay C, Komurcu M. Functional treatment of developmental hip dysplasia with the Tübingen hip flexion splint. Hip Int. 2014;24(3):295-301.
• 4. Atalar H, Gunay C, Komurcu M. Functional treatment of developmental hip dysplasia with the Tübingen hip flexion splint. Hip International. 2014;24(3):295-301.
• 5. Köse N, Ömeroğlu H, Özyurt B, Akçar N, Özçelik A, İnan U, et al. Üç-dört haftalık bebeklerde yürütülen ultrasonografik kalça taraması programında üç yıllık deneyimimiz. Acta Orthop Traumatol Turc. 2006.
• 6. Pavone V, Testa G, Riccioli M, Evola FR, Avondo S, Sessa G. Treatment of developmental dysplasia of hip with Tubingen hip flexion splint. Journal of Pediatric Orthopaedics. 2015;35(5):485-9.
• 7. van de Sande MA, Melisie F. Successful Pavlik treatment in late-diagnosed developmental dysplasia of the hip. International orthopaedics. 2012;36(8):1661-8.
• 8. van der Sluijs JA, De Gier L, Verbeke JI, Witbreuk MM, Pruys JE, van Royen BJ. Prolonged treatment with the Pavlik harness in infants with developmental dysplasia of the hip. J Bone Joint Surg Br. 2009;91(8):1090-3.
• 9. Walton M, Isaacson Z, McMillan D, Hawkes R, Atherton W. The success of management with the Pavlik harness for developmental dysplasia of the hip using a United Kingdom screening programme and ultrasound-guided supervision. The Journal of Bone and Joint Surgery British volume. 2010;92(7):1013-6.
• 10. Seidl T, Lohmaier J, Hölker T, Funk J, Placzek R, Trouillier H. Reduction of unstable and dislocated hips applying the Tübingen hip flexion splint? Der Orthopade. 2012;41(3):195-9.
• 11. Bin K, Laville J-M, Salmeron F. Developmental dysplasia of the hip in neonates: Evolution of acetabular dysplasia after hip stabilization by brief Pavlik harness treatment. Orthopaedics & Traumatology: Surgery & Research. 2014;100(4):357-61.
• 12. Atalar H, Arıkan M, Yavuz O, Kınık H, Şaylı U. Gelişimsel kalça displazisinin pavlik bandajı ile konservatif tedavisindeki önemli noktalar. Türkiye Klinikleri J Med Sci. 2005.
• 13. Uçar DH, Isklar ZU, Kandemir U, Tümer Y. Treatment of developmental dysplasia of the hip with Pavlik harness: prospective study in Graf type IIc or more severe hips. Journal of Pediatric Orthopaedics B. 2004;13(2):70-4.
• 14. Uras I, Yavuz OY, Uygun M, Yldrm H, Kömürcü M. The efficacy of semirigid hip orthosis in the delayed treatment of developmental dysplasia of the hip. Journal of Pediatric Orthopaedics B. 2014;23(4):339-42.
• 15. Grill F, Bensahel H, Cañadell J, Dungl P, Matasovic T, Vizkelety ^HT. The Pavlik harness in the treatment of congenital dislocating hip: report on a multicenter study of the European Paediatric Orthopaedic Society. 1988.
• 16. Akhtar A, Farhan Y, Shami A. Developmental Dysplasia of Hip: Role of Clinical Examination. Journal of Islamabad Medical & Dental College (JIMDC). 2015;4(3):122-4.
• 17. Peled E, Bialik V, Katzman A, Eidelman M, Norman D. Treatment of Graf’s ultrasound class III and IV hips using Pavlik’s method. Clinical orthopaedics and related research. 2008;466:825-9.
• 18. MO T. Tachdjian pediatric orthopedics. Pilhadelphia: Saunders. 1990:2009-82.
• 19. Vadillo P, Encinas-Ullan CA, Moraleda L, Albinana J. Results of the Pavlik harness when treating Ortolani-positive hips: predictors of failure and arthrographic findings. J Child Orthop. 2015;9(4):249-53.