Splintage in developmental dysplasia of the hip: how low can we go?

The indications for using abduction splints in developmental dysplasia of the hip (DDH) are not clearly defined. In this study, the authors prospectively evaluated 797 babies born between 1996 and 1998 as part of a limited targeted ultrasound screening program. In the first group (1996-97), babies with clinical hip instability at first scan were placed in a Pavlik harness. In the second group (1998), only babies who had persistent instability at 2 weeks were splinted. Children with persistent major dysplasia at 9 weeks were splinted in both groups. The splintage rate was 1.6/1,000 live births in the first group and 0.8/1,000 live births in the second group. The rate of surgery for DDH did not increase despite a significant decrease in the number of babies being splinted. This study demonstrates that a splintage rate as low as 1.3/1,000 live births (average rate for 1996-98) can be achieved without adversely affecting the outcomes following treatment of DDH.