Sonographic Assessment of Hip Swaddling Techniques in Infants With and Without DDH
| Autor: | J R Bowen, Ali F. Karatas, Susan Cummings, Howard T. Harcke |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Joint Instability
Male musculoskeletal diseases Orthotic Devices medicine.medical_specialty Pilot Projects Swaddling 03 medical and health sciences Femoral head 0302 clinical medicine 030225 pediatrics medicine Humans Orthopedics and Sports Medicine Pavlik harness Prospective Studies Range of Motion Articular Hip Dislocation Congenital 030222 orthopedics Developmental dysplasia business.industry Infant Newborn Infant Femur Head General Medicine Surgery medicine.anatomical_structure Limited flexion Infant Care Pediatrics Perinatology and Child Health Female Level ii Range of motion business |
| Zdroj: | Journal of Pediatric Orthopaedics. 36:232-238 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000000446 |
| Popis: | Background The purpose of this single-examination pilot study was to confirm the ability to perform hip sonography while swaddled and to ascertain whether the various swaddling techniques influenced hip position and dynamics. Methods Dynamic sonography was used to evaluate 30 infants in both swaddled and unswaddled positions who were being seen in clinic for suspected or documented developmental dysplasia of the hip. A "treatment group" of 16 infants (32 hips) treated in a Pavlik harness and a "nontreatment group" of 14 untreated infants (28 hips) were studied.Criteria for comparing sonographic results between swaddled and unswaddled hip positions included femoral head position, instability, and range-of-motion restriction. Results Tight swaddling with a blanket was applied in 11 "nontreatment group" cases (20 hips; in 2 cases, only 1 hip studied) and produced limited flexion and abduction. One unstable left hip dislocated when tightly swaddled. Safe swaddling technique in 12 cases (24 hips) showed no limitation of flexion and abduction of the legs and no change in stability by sonography. Commercial swaddling products appeared to mildly restrict leg motion in 14 hips, but there was no change in hip position in the "nontreatment group." However, the commercial swaddling products changed the hip position in 3 Pavlik harness cases. Conclusions Swaddling techniques that allow a free range of leg motion may not affect hip stability in normal infants or those being treated with Pavlik harness. Swaddling with restricted leg motion increases potential for hip instability. Tight swaddling dislocated 1 unstable hip, and commercial swaddling products judged to apply only mild restriction of leg motion negatively impacted 3 cases being treated for developmental dysplasia of the hip with Pavlik harness. On the basis of this pilot study, we advise caution when swaddling infants, especially with techniques that restrict leg motion. Further study of the long-term effects of swaddling is warranted. Level of evidence Level II. |
| Databáze: | OpenAIRE |
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