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Closed reduction and dynamic cast immobilization in patients with developmental dysplasia of the hip between 6 and 24 months of age

  • YiQiang Li
  • QingHe Zhou
  • Yuanzhong Liu
  • WeiDong Chen
  • JingChun Li
  • Federico Canavese
  • HongWen Xu
Original Article • HIP - PAEDIATRICS
  • 79 Downloads

Abstract

Background

Closed reduction and spica cast is still the preferred treatment option for children presenting with developmental dysplasia of the hip (DDH) after the age of 6 months. This study aims to investigate the outcomes of patients with DDH treated by closed reduction and dynamic cast immobilization.

Methods

In total, 159 patients (mean age 15.6 ± 4.2 months; 172 hips) were treated with a dynamic cast immobilization for 3 months, followed by an abduction brace until a stable concentric reduction was achieved. Radiological examination was performed at each follow-up visit to assess reduction, redislocation rate and presence of avascular necrosis (AVN) of the femoral epiphysis. Final radiographic results were evaluated with the Severin classification.

Results

The redislocation rate was 4.1% (7/172); the overall AVN rate was 14.5% (grade II: 16 hips; grade III: 5 hips; grade IV: 3 hips). At last follow-up visit, the mean age of patients was 61.6 ± 21.3 months (range 30.8–141), and the mean acetabular index was 22.6° ± 5.6°; 67.3% of the hips had Severin type I radiographic criteria, 8.5% had type II, 23.6% had type III, and 0.6% had type IV.

Conclusions

Dynamic cast is an alternative to spica cast immobilization in DDH patients undergoing closed reduction. It has similar redislocation and AVN rates compared to standard spica cast immobilization, as reported by previous studies.

Keywords

Developmental dysplasia of the hip Dynamic cast immobilization Redislocation Avascular necrosis of the femoral epiphysis 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

No patients were involved. This is a retrospective study of patient’s data, and an IRB approval was obtained.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric Orthopaedics, Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina
  2. 2.Pediatric Surgery DepartmentUniversity Hospital Estaing Clermont FerrandClermont FerrandFrance

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