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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-06-2022 | Hip Dysplasia | Orthopaedic Surgery

Results after spica cast immobilization following hip reconstruction in 95 cases: is there a need for alternative techniques?

Authors: L. Pisecky, G. Großbötzl, M. Gahleitner, C. Haas, T. Gotterbarm, M. C. Klotz

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2022

Abstract

Introduction

Developmental dysplasia of the hip (DDH), neurogenic dysplasia of the hip (NDH), and Perthes disease often require surgical treatment. Spica casting is a common postoperative immobilization.

The purpose of this study was to evaluate the complications related to the immobilization.

Materials and methods

In a retrospective analysis, we included 83 patients (95 hips), who underwent hip reconstructive surgery between 2008 and 2018. We had 43 female and 40 male patients. Age reached from 3 months to 19 years. All patients were treated with a spica cast postoperatively for a 6-week protocol. Complications were analyzed using the full medical documentation and classified according to Clavien–Dindo.

Results

We had complications in 23 patients (27.7%). We counted superficial skin lesions in seven, deep skin lesions in three, spasticity of adductors in three, subluxation in two, infection of the plate in one, fracture of the plate in one, compliance problem in one, dislocations of the cast in two, reluxation in one, delayed bone healing in one and spasticity of knee flexors in one case. According to the classification of Clavien–Dindo, we were able to count ten type I, four type II, nine type III, zero type IV and zero type V adverse events.

Conclusion

The usage of a spica cast after hip reconstructive surgery is still the most popular way of aftertreatment. It has a low complication rate, which may be lowered by well-applied casts and foam padding. Known complications such as spasticity in patients with cerebral palsy, skin lesions, and pressure sores should be observed and avoided. Shorter protocols for immobilization with the usage of foam padding and foam splints lead to less complications.

Clinical relevance

Evidence level level IV, case series

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Title: Results after spica cast immobilization following hip reconstruction in 95 cases: is there a need for alternative techniques?
Authors: L. Pisecky
G. Großbötzl
M. Gahleitner
C. Haas
T. Gotterbarm
M. C. Klotz
Publication date: 01-06-2022
Publisher: Springer Berlin Heidelberg
Keyword: Hip Dysplasia
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03733-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Results after spica cast immobilization following hip reconstruction in 95 cases: is there a need for alternative techniques?

Abstract

Introduction

Materials and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Clinical relevance

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