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Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review

Background: Developmental dysplasia of the hip (DDH) is one of the most common pediatric conditions. The current gold-standard treatment for children under six months of age with a reducible hip is bracing, but the orthopedic literature features several splint options, and each one has many advantag...

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Autores principales: Pavone, Vito, de Cristo, Claudia, Vescio, Andrea, Lucenti, Ludovico, Sapienza, Marco, Sessa, Giuseppe, Pavone, Piero, Testa, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913860/
https://www.ncbi.nlm.nih.gov/pubmed/33557053
http://dx.doi.org/10.3390/children8020104
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author Pavone, Vito
de Cristo, Claudia
Vescio, Andrea
Lucenti, Ludovico
Sapienza, Marco
Sessa, Giuseppe
Pavone, Piero
Testa, Gianluca
author_facet Pavone, Vito
de Cristo, Claudia
Vescio, Andrea
Lucenti, Ludovico
Sapienza, Marco
Sessa, Giuseppe
Pavone, Piero
Testa, Gianluca
author_sort Pavone, Vito
collection PubMed
description Background: Developmental dysplasia of the hip (DDH) is one of the most common pediatric conditions. The current gold-standard treatment for children under six months of age with a reducible hip is bracing, but the orthopedic literature features several splint options, and each one has many advantages and disadvantages. The aim of this review is to analyze the available literature to document the up-to-date evidence on DDH conservative treatment. Methods: A systematic review of PubMed and Science Direct databases was performed by two independent authors (C.d.C. and A.V.) using the keywords “developmental dysplasia hip”, “brace”, “harness”, “splint”, “abduction brace” to evaluate studies of any level of evidence that reported clinical or preclinical results and dealt with conservative DDH treatment. The result of every stage was reviewed and approved by the senior investigators (V.P. and G.T.). Results: A total of 1411 articles were found. After the exclusion of duplicates, 367 articles were selected. At the end of the first screening, following the previously described selection criteria, we selected 29 articles eligible for full text reading. The included articles mainly focus on the Pavlik harness, Frejka, and Tubingen among the dynamic splint applications as well as the rhino-style brace, Ilfeld and generic abduction brace among the static splint applications. The main findings of the included articles were summarized. Conclusions: Dynamic splinting for DDH represents a valid therapeutic option in cases of instability and dislocation, especially if applied within 4–5 months of life. Dynamic splinting has a low contraindication. Static bracing is an effective option too, but only for stable hips or residual acetabular dysplasia.
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spelling pubmed-79138602021-02-28 Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review Pavone, Vito de Cristo, Claudia Vescio, Andrea Lucenti, Ludovico Sapienza, Marco Sessa, Giuseppe Pavone, Piero Testa, Gianluca Children (Basel) Review Background: Developmental dysplasia of the hip (DDH) is one of the most common pediatric conditions. The current gold-standard treatment for children under six months of age with a reducible hip is bracing, but the orthopedic literature features several splint options, and each one has many advantages and disadvantages. The aim of this review is to analyze the available literature to document the up-to-date evidence on DDH conservative treatment. Methods: A systematic review of PubMed and Science Direct databases was performed by two independent authors (C.d.C. and A.V.) using the keywords “developmental dysplasia hip”, “brace”, “harness”, “splint”, “abduction brace” to evaluate studies of any level of evidence that reported clinical or preclinical results and dealt with conservative DDH treatment. The result of every stage was reviewed and approved by the senior investigators (V.P. and G.T.). Results: A total of 1411 articles were found. After the exclusion of duplicates, 367 articles were selected. At the end of the first screening, following the previously described selection criteria, we selected 29 articles eligible for full text reading. The included articles mainly focus on the Pavlik harness, Frejka, and Tubingen among the dynamic splint applications as well as the rhino-style brace, Ilfeld and generic abduction brace among the static splint applications. The main findings of the included articles were summarized. Conclusions: Dynamic splinting for DDH represents a valid therapeutic option in cases of instability and dislocation, especially if applied within 4–5 months of life. Dynamic splinting has a low contraindication. Static bracing is an effective option too, but only for stable hips or residual acetabular dysplasia. MDPI 2021-02-04 /pmc/articles/PMC7913860/ /pubmed/33557053 http://dx.doi.org/10.3390/children8020104 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Pavone, Vito
de Cristo, Claudia
Vescio, Andrea
Lucenti, Ludovico
Sapienza, Marco
Sessa, Giuseppe
Pavone, Piero
Testa, Gianluca
Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review
title Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review
title_full Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review
title_fullStr Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review
title_full_unstemmed Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review
title_short Dynamic and Static Splinting for Treatment of Developmental Dysplasia of the Hip: A Systematic Review
title_sort dynamic and static splinting for treatment of developmental dysplasia of the hip: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913860/
https://www.ncbi.nlm.nih.gov/pubmed/33557053
http://dx.doi.org/10.3390/children8020104
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