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

Abstract

Purpose To investigate the success rate of the Tübingen hip flexion splint (THFS) for the treatment of developmental dysplasia of the hip (DDH), of different severity as per the Graf classification, among infants younger than six months of age. The type and incidence rate of complications associated with THFS treatment were also evaluated. Methods The following databases were searched using keywords and limited for age less than six months: PubMed, Embase, Web of Science, Cochrane Library, and SinoMed, between inception and July 2020. Articles were screened and extracted by two researchers, and the quality of the included literature was evaluated (methodological index for non-randomized studies criteria). R studio 1.3 was used for statistical analysis. The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results After screening, eight articles were included in the analysis, contributing 1211 hips (875 patients). The overall success rate of THFS treatment is 91% (95% confidence interval (CI) 0.82 to 0.95). The success rate by Graf type is as follows: type-II, 98% (95% CI 0.94 to 1.00); type-III, 96% (95% CI 0.88 to 1.00); and type-IV, 32% (95% CI 0.18 to 0.47). Complications (24/1211, 2%) included transient femoral nerve palsy (n = 1); avascular necrosis of the femoral head (n = 9) and residual acetabular dysplasia (n = 14). Conclusion THFS treatment is successful for Graf type-II and –III, but low for type-IV, with a low rate of complication. THFS may be an effective treatment option for DDH among infants less than six months of age. However, those with Graf type-IV require close monitoring. Level of Evidence: III

Radiological long-term follow-up up to 12 years of initially ultrasound unstable hip types D, III and IV after treatment with the Tübingen splint worn as a plaster

“…This is in accordance to our data with 98.9% success rate of type D and 95.3% success rate of type III hips. On the other hand, the success rate of 32.0% for type IV hips was very low (with statistically low heterogeneity in the study group) [17]. These data were significantly inferior to the results of the present study showing a success rate of 81.2% for type IV hips.…”

“…The above-mentioned success rate of 95.5% is comparable with previous studies, which examined the therapy of ultrasound unstable hips with the Tübingen splint. Here, success rates of 92.3-98.0% were observed [10][11][12]17]. Seidl et al found in their study with 52 ultrasound unstable hips a success rate of 98.0% [11].…”

Kūdikių Displazijos Gydymo Būdai

“…Laikysenos defektai, skoliozė ir skausmingi funkciniai bei struktūriniai juosmeninės ir kryžmeninės stuburo dalių pakitimai priskiriami prie negydomų arba nepakankamai gydomų KVD patologijos sukeltų raumenų ir skeleto funkcijų sutrikimų [20]. Dėl šių bei kitų panašių anomalijų, atsiradusių ankstyvųjų ar vėlyvųjų problemų, susijusių su KVD, sutrinka statinės bei dinaminės funkcijos [51]. KVD patologijos kontekste svarbus vidurinis sėdmens raumuo, priklausantis šlaunies atitraukiamųjų raumenų grupei [48].…”