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Review
. 2021 Feb 4;8(2):104.
doi: 10.3390/children8020104.

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

Vito Pavone  1 , Claudia de Cristo  1 , Andrea Vescio  1 , Ludovico Lucenti  1 , Marco Sapienza  1 , Giuseppe Sessa  1 , Piero Pavone  2 , Gianluca Testa  1
Affiliations
Review

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

Vito Pavone et al. Children (Basel). .

Abstract

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.

Keywords: DDH; bracing; conservative; developmental dysplasia of the hip; dynamic splint; static splint; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flowchart of the systematic literature review.
Figure 2
Figure 2
Forest plot of comparison: dynamic vs. static bracing/splinting. M-H = Mantel-Haenszel method; CI = confidence interval; arrow = overall effect, square = point estimate and confidence intervals of study; diamond = point estimate and confidence intervals for type of brace/splint.
See this image and copyright information in PMC

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