Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up
Closed reduction followed by spica casting is a conservative treatment for developmental dysplasia of the hip (DDH). Magnetic resonance imaging (MRI) can verify proper closed reduction of the dysplastic hip. Our aim was to find prognostic factors in the first MRI to predict the possible outcome of t...
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| Format: | Article |
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MDPI AG
2022-07-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/7/1010 |
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| author | Katharina Susanne Gather Ivan Mavrev Simone Gantz Thomas Dreher Sébastien Hagmann Nicholas Andreas Beckmann |
| author_facet | Katharina Susanne Gather Ivan Mavrev Simone Gantz Thomas Dreher Sébastien Hagmann Nicholas Andreas Beckmann |
| author_sort | Katharina Susanne Gather |
| collection | DOAJ |
| description | Closed reduction followed by spica casting is a conservative treatment for developmental dysplasia of the hip (DDH). Magnetic resonance imaging (MRI) can verify proper closed reduction of the dysplastic hip. Our aim was to find prognostic factors in the first MRI to predict the possible outcome of the initial treatment success by means of ultrasound monitoring according to Graf and the further development of the hip dysplasia or risk of recurrence in the radiological follow-up examinations. A total of 48 patients (96 hips) with DDH on at least one side, and who were treated with closed reduction and spica cast were included in this retrospective cohort study. Treatment began at a mean age of 9.9 weeks. The children were followed for 47.4 months on average. We performed closed reduction and spica casting under general balanced anaesthesia. This was directly followed by MRI to control the position/reduction of the femoral head without anaesthesia. The following parameters were measured in the MRI: hip abduction angle, coronal, anterior and posterior bony axial acetabular angles and pelvic width. A Graf alpha angle of at least 60° was considered successful. In the radiological follow-up controls, we evaluated for residual dysplasia or recurrence. In our cohort, we only found the abduction angle to be an influencing factor for improvement of the DDH. No other prognostic factors in MRI measurements, such as gender, age at time of the first spica cast, or treatment involving overhead extension were found to be predictive of mid-term outcomes. This may, however, be due to the relatively small number of treatment failures. |
| first_indexed | 2024-03-09T10:21:05Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T10:21:05Z |
| publishDate | 2022-07-01 |
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| record_format | Article |
| series | Children |
| spelling | doaj.art-3e76cf656a394c41b900b346d5c511ca2023-12-01T22:01:40ZengMDPI AGChildren2227-90672022-07-0197101010.3390/children9071010Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-UpKatharina Susanne Gather0Ivan Mavrev1Simone Gantz2Thomas Dreher3Sébastien Hagmann4Nicholas Andreas Beckmann5Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, GermanyClinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, GermanyClinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, GermanyPediatric Orthopedics and Traumatology, Children’s University Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, SwitzerlandClinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, GermanyClinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, GermanyClosed reduction followed by spica casting is a conservative treatment for developmental dysplasia of the hip (DDH). Magnetic resonance imaging (MRI) can verify proper closed reduction of the dysplastic hip. Our aim was to find prognostic factors in the first MRI to predict the possible outcome of the initial treatment success by means of ultrasound monitoring according to Graf and the further development of the hip dysplasia or risk of recurrence in the radiological follow-up examinations. A total of 48 patients (96 hips) with DDH on at least one side, and who were treated with closed reduction and spica cast were included in this retrospective cohort study. Treatment began at a mean age of 9.9 weeks. The children were followed for 47.4 months on average. We performed closed reduction and spica casting under general balanced anaesthesia. This was directly followed by MRI to control the position/reduction of the femoral head without anaesthesia. The following parameters were measured in the MRI: hip abduction angle, coronal, anterior and posterior bony axial acetabular angles and pelvic width. A Graf alpha angle of at least 60° was considered successful. In the radiological follow-up controls, we evaluated for residual dysplasia or recurrence. In our cohort, we only found the abduction angle to be an influencing factor for improvement of the DDH. No other prognostic factors in MRI measurements, such as gender, age at time of the first spica cast, or treatment involving overhead extension were found to be predictive of mid-term outcomes. This may, however, be due to the relatively small number of treatment failures.https://www.mdpi.com/2227-9067/9/7/1010spica castclosed reductiondevelopmental hip dysplasiahip luxationMRI |
| spellingShingle | Katharina Susanne Gather Ivan Mavrev Simone Gantz Thomas Dreher Sébastien Hagmann Nicholas Andreas Beckmann Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up Children spica cast closed reduction developmental hip dysplasia hip luxation MRI |
| title | Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up |
| title_full | Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up |
| title_fullStr | Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up |
| title_full_unstemmed | Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up |
| title_short | Outcome Prognostic Factors in MRI during Spica Cast Therapy Treating Developmental Hip Dysplasia with Midterm Follow-Up |
| title_sort | outcome prognostic factors in mri during spica cast therapy treating developmental hip dysplasia with midterm follow up |
| topic | spica cast closed reduction developmental hip dysplasia hip luxation MRI |
| url | https://www.mdpi.com/2227-9067/9/7/1010 |
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