Abstract
Developmental dysplasia of the hip (DDH) is a condition that varies greatly in severity. The mildest forms of DDH have great potential for spontaneous recovery, as more severe forms usually need an abduction treatment. In the most severe forms of DDH and the cases of failed abduction treatments, an operative treatment may be needed. Known risk factors of DDH include a positive family history, the female sex, and breech presentation. This study aimed to further evaluate the risk factors of DDH: their relations to the severity of the disease, treatment failures, and the treatment duration. Another aim was to evaluate the costs of a successful abduction treatment.
The study material was collected retrospectively. All the children with a diagnosis of DDH and treated in Tampere University Hospital in the years 1998-2018 were found, and data was collected from their medical records. Only the children who started and finished the treatment at Tampere University Hospital were included. A total of 948 patients were found.
We found that multiple risk factors are associated with the severity of DDH, the rate of improvement in DDH, and the failure of the treatment. According to our findings, a positive family history is a risk factor that may predispose children to the most severe forms of DDH, and children with a family history of DDH may need special attention regarding their treatment protocol and follow-up. Girls tend to need longer abduction treatments than boys, and their recovery is slower than boys. Breech presentation predisposes children to more severe forms of DDH, but these patients recover well and fast with the right treatment. We also found that the watchful waiting strategy in mild DDH cases is cost-effective with the right patient selection.
Our findings give new information about the known risk factors of DDH, as well as the exact recovery process in DDH. Our findings also encourage clinicians to use a watchful waiting strategy as part of their treatment protocol when treating mild DDH.
The study material was collected retrospectively. All the children with a diagnosis of DDH and treated in Tampere University Hospital in the years 1998-2018 were found, and data was collected from their medical records. Only the children who started and finished the treatment at Tampere University Hospital were included. A total of 948 patients were found.
We found that multiple risk factors are associated with the severity of DDH, the rate of improvement in DDH, and the failure of the treatment. According to our findings, a positive family history is a risk factor that may predispose children to the most severe forms of DDH, and children with a family history of DDH may need special attention regarding their treatment protocol and follow-up. Girls tend to need longer abduction treatments than boys, and their recovery is slower than boys. Breech presentation predisposes children to more severe forms of DDH, but these patients recover well and fast with the right treatment. We also found that the watchful waiting strategy in mild DDH cases is cost-effective with the right patient selection.
Our findings give new information about the known risk factors of DDH, as well as the exact recovery process in DDH. Our findings also encourage clinicians to use a watchful waiting strategy as part of their treatment protocol when treating mild DDH.
| Original language | English |
|---|---|
| Place of Publication | Tampere |
| Publisher | Tampere University |
| ISBN (Electronic) | 978-952-03-3461-1 |
| ISBN (Print) | 978-952-03-3460-4 |
| Publication status | Published - 2024 |
| Publication type | G5 Doctoral dissertation (articles) |
Publication series
| Name | Tampere University Dissertations - Tampereen yliopiston väitöskirjat |
|---|---|
| Volume | 1031 |
| ISSN (Print) | 2489-9860 |
| ISSN (Electronic) | 2490-0028 |