A systematic review of the biomechanics of orthopaedic ambulatory bracing for residual hip dysplasia

Background: Residual hip dysplasia may occur following initial treatment of developmental dysplasia of the hip during infancy or following surgical intervention at an older age. Mild hip dysplasia may also be discovered during early childhood. Treatments include modalities such as bracing for less severe cases and surgical intervention for more severe cases. Treatment strategies involving bracing often cease around one year of age as children change ambulatory status and become more mobile. Continued bracing with an ambulation-permitting brace may fill the gap between the common bracing treatments and the advanced need for surgical intervention. This study sought to determine whether the biomechanics of ambulatory abduction bracing have been adequately studied as an alternative to observation for mild residual dysplasia in the ambulatory toddler. Methods: This systematic review on the topic was only able to identify seven studies that address bracing of children with developmental dysplasia of the hip while also of ambulatory age. Findings: Of these seven studies identified, there was very little clinically useful information to provide a basis for ambulatory bracing for mild residual hip dysplasia. Interpretation: This study motivates the need for future work in this largely understudied area.