Long-term outcome of early treatment of developmental hip dysplasia using an abduction splint.

Background. Treatment of congenital hip dysplasia, when implemented in the first weeks of life, gives a good outcome. Very few publications, however, have addressed the anatomical remodeling of the affected hip. In this study, we evaluate the anatomical outcome of the treatment applied. Material and methods. We examined 89 children diagnosed with congenital hip dysplasia in the first three months of life and then treated with an abduction device, for a total of 148 hips. The time of follow-up varied from 8 to 13 years. All these children were given a clinical examination according to McKay, along with Severin X-ray classification. Results. Before treatment was implemented, the patients had been diagnosed as types IIc (56 hips, 37.8%), IId (34 hips, 22.9%), III (40 hips, 27.1%), and IV (18 hips, 12.2%). In one hip final assessment showed signs of aseptic necrosis of the proximal femur. 147 hips showed total remodeling, and in the Severin X-ray classification scheme were evaluated as type I. Conclusions. Severin X-ray clasification is easy to implement and in our material corresponds with the clinical evaluation according to McKay. Early implementation of treatment with an abduction device is worthwhile and gives a satisfactory outcome.