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Early treatment with the von Rosen splint for neonatal instability of the hip is safe regarding avascular necrosis of the femoral head.

Wenger, Daniel LU ; Samuelsson, Hanna; Düppe, Henrik LU and Tiderius, Carl Johan LU (2016) In Acta Orthopaedica 87(2). p.169-175
Abstract
Background and purpose - Avascular necrosis of the femoral head (AVN) is a complication in treatment of developmental dysplasia of the hip (DDH). We evaluated the risk of AVN after early treatment in the von Rosen splint and measured the diameter of the ossific nucleus at 1 year of age. Children and methods - All children born in Malmö, Sweden, undergo clinical screening for neonatal instability of the hip (NIH). We reviewed 1-year radiographs of all children treated early for NIH in our department from 2003 through 2010. The diameter of the ossific nucleus was measured, and signs of AVN were classified according to Kalamchi-MacEwen. Subsequent radiographs, taken for any reason, were reviewed and a local registry of diagnoses was used to... (More)
Background and purpose - Avascular necrosis of the femoral head (AVN) is a complication in treatment of developmental dysplasia of the hip (DDH). We evaluated the risk of AVN after early treatment in the von Rosen splint and measured the diameter of the ossific nucleus at 1 year of age. Children and methods - All children born in Malmö, Sweden, undergo clinical screening for neonatal instability of the hip (NIH). We reviewed 1-year radiographs of all children treated early for NIH in our department from 2003 through 2010. The diameter of the ossific nucleus was measured, and signs of AVN were classified according to Kalamchi-MacEwen. Subsequent radiographs, taken for any reason, were reviewed and a local registry of diagnoses was used to identify subsequent AVN. Results - 229 of 586 children referred because of suspected NIH received early treatment (age ≤ 1 week) for NIH during the study period. 2 of the 229 treated children (0.9%, 95% CI: 0.1-3.1) had grade-1 AVN. Both had spontaneous resolution and were asymptomatic during the observation time (6 and 8 years). 466 children met the inclusion criteria for measurement of the ossific nucleus. Neonatally dislocated hips had significantly smaller ossific nuclei than neonatally stable hips: mean 9.4 mm (95% CI: 9.1-9.8) vs. 11.1 mm (95% CI: 10.9-11.3) at 1 year (p < 0.001). Interpretation - Early treatment with the von Rosen splint for NIH is safe regarding AVN. The ossification of the femoral head is slower in children with NIH than in untreated children with neonatally stable hips. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
87
issue
2
pages
169 - 175
publisher
Taylor & Francis
external identifiers
  • PMID:26730503
  • Scopus:84953212739
  • WOS:000372447400014
ISSN
1745-3682
DOI
10.3109/17453674.2015.1126158
language
English
LU publication?
yes
id
c38b4df0-d909-42f5-971f-d1fc0f1286da (old id 8593168)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26730503?dopt=Abstract
date added to LUP
2016-02-01 19:48:39
date last changed
2016-10-13 04:23:28
@misc{c38b4df0-d909-42f5-971f-d1fc0f1286da,
  abstract     = {Background and purpose - Avascular necrosis of the femoral head (AVN) is a complication in treatment of developmental dysplasia of the hip (DDH). We evaluated the risk of AVN after early treatment in the von Rosen splint and measured the diameter of the ossific nucleus at 1 year of age. Children and methods - All children born in Malmö, Sweden, undergo clinical screening for neonatal instability of the hip (NIH). We reviewed 1-year radiographs of all children treated early for NIH in our department from 2003 through 2010. The diameter of the ossific nucleus was measured, and signs of AVN were classified according to Kalamchi-MacEwen. Subsequent radiographs, taken for any reason, were reviewed and a local registry of diagnoses was used to identify subsequent AVN. Results - 229 of 586 children referred because of suspected NIH received early treatment (age ≤ 1 week) for NIH during the study period. 2 of the 229 treated children (0.9%, 95% CI: 0.1-3.1) had grade-1 AVN. Both had spontaneous resolution and were asymptomatic during the observation time (6 and 8 years). 466 children met the inclusion criteria for measurement of the ossific nucleus. Neonatally dislocated hips had significantly smaller ossific nuclei than neonatally stable hips: mean 9.4 mm (95% CI: 9.1-9.8) vs. 11.1 mm (95% CI: 10.9-11.3) at 1 year (p &lt; 0.001). Interpretation - Early treatment with the von Rosen splint for NIH is safe regarding AVN. The ossification of the femoral head is slower in children with NIH than in untreated children with neonatally stable hips.},
  author       = {Wenger, Daniel and Samuelsson, Hanna and Düppe, Henrik and Tiderius, Carl Johan},
  issn         = {1745-3682},
  language     = {eng},
  month        = {01},
  number       = {2},
  pages        = {169--175},
  publisher    = {ARRAY(0x9eca3c0)},
  series       = {Acta Orthopaedica},
  title        = {Early treatment with the von Rosen splint for neonatal instability of the hip is safe regarding avascular necrosis of the femoral head.},
  url          = {http://dx.doi.org/10.3109/17453674.2015.1126158},
  volume       = {87},
  year         = {2016},
}