Weight Percentile Is Maintained During Spica Casting: A Retrospective Cohort Study of Patients Treated with Closed or Open Reduction for Developmental Dysplasia of the Hip.

Olivia C Tracey, Kiranpreet Nagra, Keza Levine, Akshitha Adhiyaman, Paige McBoyle, Erikson Nichols, Melanie Prior, Ernest L Sink, David Scher, Shevaun M Doyle, Emily Dodwell
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Abstract

Background: Weight changes during spica casting previously have not been reported. The primary aim of this study was to determine weight percentile change from cast initiation to cast removal. Secondary aims were to assess weight percentile changes from initiation to mid-term follow-up visits after cast removal and to assess the mean weight change from cast initiation to cast removal.

Methods: Patients with developmental dysplasia of the hip (DDH) treated with closed or open reduction (± ​femoral/pelvic osteotomy) and spica cast were retrospectively reviewed from 2/2016-6/2023. Patients aged <4 years treated for ≥6 weeks in spica cast were included. Patients lacking weight measurements within the 4 weeks prior to cast initiation or within 2 weeks following cast removal were excluded. Demographics, weight, and weight percentiles at cast initiation, cast removal, and at follow-ups were collected. Mean weights and mean weight percentiles were compared across visits with dependent sample t-tests and one-way analysis of variance tests based on normality, with a significance threshold of P ​≤ ​.05.

Results: Thirty-six hips in 31 infants (median age: 10.4 [interquartile range {IQR}: 9, 16.3] months, 86% female) were included. The median duration of casting was 9.2 [IQR: 7.9, 12.6] weeks; 2 hips had midpoint cast change. The mean weight was 9.8 ​± ​2.3 ​kg at cast initiation and 10.1 ​± ​1.9 ​kg at final cast removal, with a mean change of 0.3 ​± ​0.4 ​kg (P ​= ​.527). Mean weight percentiles did not differ during or after treatment (range: 55-61st percentile, P ​= ​.974).

Conclusion: Weight percentiles were maintained during spica casting in the patients examined in this study, which should be reassuring to the family and treatment team; our study did not find that spica casting stunts weight gain. For surgeons who may consider maintaining the original spica cast throughout treatment, without cast change, a mean weight gain of 0.3 ​kg for a mean casting length of 9 weeks in infants of median age 10.4 months should be reassuring; many infants/toddlers may not require a cast change due to growth.

Key concepts: (1)Spica casting does not appear to stunt weight gain.(2)The weight percentile did not change during spica casting following open or closed reduction for developmental dysplasia of the hip.(3)The mean weight gain during typical spica casting is 0.3 ​kg, which was not statistically significant.

Level of evidence: III, retrospective cohort.

Spica铸造期间保持体重百分位数:一项对髋关节发育不良患者进行闭合或开放复位治疗的回顾性队列研究。
背景:体重变化在spica铸造以前没有报道。本研究的主要目的是确定从铸型起始到去除铸型的体重百分位数变化。次要目的是评估从石膏取出后开始到中期随访的体重百分位数变化,以及评估从石膏取出到开始的平均体重变化。方法:回顾性分析2016年2月- 2023年6月行闭合或开放复位(±股骨/骨盆截骨术)和spica石膏治疗的发育性髋关节发育不良(DDH)患者。患者年龄t检验和基于正态性的单因素方差检验,显著性阈值P≤0.05。结果:纳入31例婴儿36髋(中位年龄:10.4[四分位数间距{IQR}: 9,16.3]个月,86%为女性)。中位铸型持续时间为9.2周[IQR: 7.9, 12.6]周;2髋中点石膏改变。铸型起始时的平均体重为9.8±2.3 kg,最终取下时的平均体重为10.1±1.9 kg,平均变化为0.3±0.4 kg (P = 0.527)。治疗期间和治疗后的平均体重百分位数没有差异(范围:55-61百分位数,P = .974)。结论:本研究检查的患者在石膏铸造过程中保持体重百分位数,这应该让家庭和治疗团队放心;我们的研究并没有发现辣椒会导致体重增加。对于可能考虑在整个治疗过程中维持原有spica石膏而不更换石膏的外科医生来说,对于中位年龄10.4个月的婴儿,平均石膏长度为9周,平均体重增加0.3 kg应该是令人放心的;许多婴儿/学步儿童由于生长可能不需要更换石膏。关键概念:(1)Spica铸造似乎不会阻碍体重增加(2)Spica铸造在髋关节发育不良的开放或闭合复位期间体重百分位数没有变化(3)典型Spica铸造期间平均体重增加0.3 kg,这没有统计学意义。证据等级:III,回顾性队列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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