Ultrasonographic evaluation of infant hips in the Pavlik harness compared to body-worn commercial baby carriers.
babywearing
biomechanics
hip dysplasia
laxity
pediatric
Journal
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
Titre abrégé: J Orthop Res
Pays: United States
ID NLM: 8404726
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
16
03
2023
received:
16
11
2022
accepted:
17
04
2023
medline:
10
10
2023
pubmed:
21
4
2023
entrez:
20
04
2023
Statut:
ppublish
Résumé
While many factors contribute to development and subsequent correction of developmental hip dysplasia (DDH) in infants, hip positioning and muscle activity play a significant role. Lower-limb restrictive extension positions, such as with swaddling, are detrimental for hip development, and some baby gear leads to reduced lower limb muscle activity. Yet how baby gear impacts hip position during wear remains unclear. The purpose of this study was to compare the Graf's alpha angle and femoral head coverage of healthy infants and infants with mild DDH (instability) in the Pavlik harness and baby carriers. We obtained coronal hip ultrasound images of 10 healthy full-term infants (13.5 ± 3.4 weeks, 5F/5M) and three full-term mild DDH infants (8.9 ± 4.0 weeks, 2F/1M) in three conditions: Pavlik harness, wide-base baby carrier, and narrow-base baby carrier. Repeated measures analysis of variance was used to compare Graf's alpha angles and femoral head coverages across the conditions (p < 0.05), with post hoc pairwise tests (p < 0.0167). The Graf's alpha angle in the narrow-base carrier was 6.9° lower than the Pavlik harness, while the wide-base carrier was not different. Femoral head coverage was 10%-12% lower for the narrow-base carrier. The three mild DDH infants exhibited lower Graf's alpha angles and femoral head coverage in all measurements, with the Graf's alpha angle in the narrow-base carrier measuring 49.0°. This research demonstrated that wide-base baby carriers held hips in a position that was not significantly different from the Pavlik harness, meaning that babywearing in a wide-base carrier may have benefits for healthy hip development.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2495-2500Informations de copyright
© 2023 Orthopaedic Research Society.
Références
Swarup I, Penny CL, Dodwell ER. Developmental dysplasia of the hip: an update on diagnosis and management from birth to 6 months. Curr Opin Pediatr. 2018;30(1):84-92.
Engesaeter IØ, Lie SA, Lehmann TG, Furnes O, Vollset SE, Engesaeter LB. Neonatal hip instability and risk of total hip replacement in young adulthood. Acta Orthop. 2008;79(3):321-326.
Kilsdonk I, Witbreuk M, van der Woude HJ. Ultrasound of the neonatal hip as a screening tool for DDH: how to screen and differences in screening programs between European countries. J Ultrason. 2021;21(85):e147-e153.
Kang YR, Koo J. Ultrasonography of the pediatric hip and spine. Ultrasonography. 2017;36(3):239-251.
Harcke HT, Pruszczynski B. Hip ultrasound for developmental dysplasia: the 50% rule. Pediatr Radiol. 2017;47(7):817-821.
Salduz A, Demirel M, Akgül T, Bilgili F. An analysis of variables affecting the duration of Pavlik harness treatment: is it possible to predict the duration of treatment? Prosthet Orthot Int. 2018;42(3):299-303.
Ömeroglu H. Treatment of developmental dysplasia of the hip with the Pavlik harness in children under six months of age: indications, results and failures. J Child Orthop. 2018;12(4):308-316.
Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN Orthop. 2011;2011:1-46.
Blatt SH. To swaddle, or not to swaddle? Paleoepidemiology of developmental dysplasia of the hip and the swaddling dilemma among the indigenous populations of North America: developmental dysplasia of the hip. Am J Hum Biol. 2015;27(1):116-128.
Yamamuro T, Ishida K. Recent advances in the prevention, early diagnosis, and treatment of congenital dislocation of the hip in Japan. Clin Orthop Relat Res. 1984;184:34-40.
Graham SM, Manara J, Chokotho L, Harrison WJ. Back-carrying infants to prevent developmental hip dysplasia and its sequelae: is a new public health initiative needed? J Pediatr Orthop. 2015;35(1):57-61.
Anisfeld E, Casper V, Nozyce M, Cunningham N. Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Child Dev. 1990;61(5):1617-1627.
Siddicky SF, Bumpass DB, Krishnan A, Tackett SA, McCarthy RE, Mannen EM. Positioning and baby devices impact infant spinal muscle activity. J Biomech. 2020;104:109741.
Kirkilionis E. A baby wants to be carried: everything you need to know about baby carriers and the benefits of babywearing. Pinter & Martin; 2014.
Siddicky SF, Wang J, Rabenhorst B, Buchele L, Mannen EM. Exploring infant hip position and muscle activity in common baby gear and orthopedic devices. J Orthop Res. 2021;39(5):941-949.
Harcke HT, Karatas AF, Cummings S, Bowen JR. Sonographic assessment of hip swaddling techniques in infants with and without DDH. J Pediatr Orthop. 2016;36(3):232-238.
Price CT 2020. Infant Carrier Design Considerations Criteria for “Hip-Healthy” Designation. International Hip Dysplasia Institute, Orlando, FL. Available from https://hipdysplasia.org/wp-content/uploads/2020/05/Carrier-Design-Considerations.pdf
Fontecha CG, Coma Muñoz A, Catala Muñoz A. Evaluation by ultrasound of the hips of babies carried in baby carriers. Rev Esp Cir Ortop Traumatol (Engl Ed). 2019;63(4):289-294.
Hareendranathan AR, Wichuk S, Punithakumar K, Dulai S, Jaremko J. Normal variation of infant hip development: patterns revealed by 3D ultrasound. Bone Jt Open. 2022;3(11):913-923.
Andersson JE. Neonatal hip instability: normal values for physiological movement of the femoral head determined by an anterior-dynamic ultrasound method. J Pediatr Orthop. 1995;15(6):736-740.
Mostofi E, Chahal B, Zonoobi D, et al. Reliability of 2D and 3D ultrasound for infant hip dysplasia in the hands of novice users. Eur Radiol. 2019;29(3):1489-1495.