Dynamic long leg casting fixation for treating 12- to 18-month-old infants with developmental dysplasia of the hip

Abstract

Objective: To evaluate the effect of dynamic long leg casting in paediatric patients with developmental dysplasia of hip (DDH) diagnosed at 12–18 months. Methods: The adductor tenotomy, closed reduction, and dynamic long leg casting method was adopted to treat paediatric patients with DDH. The hips were divided into four groups according to the Tonnis radiographic dislocation classification. Groups were also classified according to the baseline acetabular index (AI): 30°–35°, 36°–40°, and > 40°. The outcomes of the reductions were evaluated according to McKay’s hip function criteria and Severin’s radiological criteria. Results: A total of 246 patients (339 hips) had complete follow-up data. After 3 months of orthosis fixation, the results were satisfactory in 264 hips (77.88%). Hip function was rated as ‘excellent’ or ‘good’ in 43 of 51 (84.31%) Tonnis type 1 hips, 125 of 155 (80.65%) type 2 hips, 70 of 90 (77.78%) type 3 hips, and 34 of 43 (79.07%) type 4 hips. The higher the baseline AI, the lower the rates of ‘excellent’ and ‘good’ hip function. Favourable radiological results (Severin types I and II) were found in 266 of 339 (78.47) hips. Conclusions: Dynamic long leg casting is an effective method for treating patients with DDH aged 12–18 months at diagnosis.