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Reduction of the dislocated hips with the Tübingen hip flexion splint in infants

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Abstract

Purpose

Early detection and conservative treatment are essential for a successful outcome in developmental dysplasia of the hip (DDH). The aim of this study was to evaluate the efficacy of Tübingen hip flexion splint treatment on dislocated hips of type D, 3, and 4 according to the Graf classification.

Methods

A total of 104 dislocated hips in 92 patients were treated with Tübingen splints. Splint treatment was applied to patients with dislocated hips as diagnosed under ultrasonographic evaluation. After four to six weeks of treatment, the hips were re-evaluated according to the Graf classification under ultrasonography. The success of Tübingen splinting was determined as follows: hips initially diagnosed as Graf type 3 and 4 were upgraded to type 2c, 2b, or 1 after treatment, and hips initially diagnosed as Graf type D were upgraded to type 2b or 1 after treatment.

Results

The mean age at treatment initiation was 11.91 ± 5.16 (range, 4–32) weeks. There were no statistically significant relationships between success rates and sex, bilateral hip involvement, or initial physical examination findings (p > 0.05). The age at the start of treatment was found to be statistically significant in terms of the success of the splint (p = 0.03).

Conclusions

For successful treatment with Tübingen splints, the cut-off point of starting initial treatment was defined as the 15th week, with sensitivity of 84.62% and specificity of 62.50%. The success rate was 75% with a successful outcome in 78 hips. In view of these results, Graf type D, 3, and 4 dislocated hips can be successfully treated with Tübingen splints.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Ankara Onkoloji Research and Training Hospital, Ankara, Turkey

    Murat Yegen

  2. Department of Orthopaedics and Traumatology, Gazi University, Faculty of Medicine, Ankara, Turkey

    Hakan Atalar & Ahmet Yigit Kaptan

  3. Department of Orthopaedics and Traumatology, Eskisehir Osmangazi University, Faculty of Medicine, Buyukdere mah., Meselik Kampusu, 26480, Eskisehir, Turkey

    Cuneyd Gunay

  4. Department of Orthopaedics and Traumatology, Private Clinic, Istanbul, Turkey

    Osman Yuksel Yavuz

  5. Department of Orthopaedics and Traumatology, Erdem Hospital, Istanbul, Turkey

    Ismail Uras

Authors
  1. Murat Yegen
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  2. Hakan Atalar
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  3. Cuneyd Gunay
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  4. Osman Yuksel Yavuz
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  5. Ismail Uras
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  6. Ahmet Yigit Kaptan
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Corresponding author

Correspondence to Cuneyd Gunay.

Ethics declarations

The institutional review board approved the chart review for this study (Number: 08.12.2014/536) and informed consent was obtained from all patients.

Conflict of interest

The authors declare that they have no conflict of interest.

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Yegen, M., Atalar, H., Gunay, C. et al. Reduction of the dislocated hips with the Tübingen hip flexion splint in infants. International Orthopaedics (SICOT) 43, 2099–2103 (2019). https://doi.org/10.1007/s00264-018-4239-6

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  • DOI: https://doi.org/10.1007/s00264-018-4239-6

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