Tübingen Hip Flexion Splint for Developmental Dysplasia of the Hip in Children and its Safety Assessment: A Systematic Review and Meta-Analysis

Background Hip dysplasia is an abnormality of the hip joint where the socket portion does not fully cover the ball portion, which might increase the risk of joint dislocation. Hip dysplasia may occur at birth or develop in early life. The purpose of the present study was to assess the effect of treatment with Tübingen hip flexion splint for Developmental Dysplasia of the Hip (DDH), and its safety. Materials and Methods: The systematicsearch was carried out on the online databases (Medline, Cochrane library, EMBASe, and Scopus) to assess the effect of treatment with Tübingen hip flexion splint for developmental dysplasia of the hip. Articles indexed until 20 April 2020 were reviewed using keywords such as (Hip dislocation, Congenital, DDH, and Tübingen hip flexion splint). The study selection was carried out by two reviewers. Results: Six studies were included in systematic review and meta-analysis. The pooled successful rate of Tübingen hip flexion splint was 88% with a Confidence Interval [CI]; 87-97%; p<0.001; heterogeneity; I2: 89%%, p<0.001; six trials; random effect model. The heterogeneity level was high among the included studies. Due to high heterogeneity, the sensitivity analysis was conducted to assess the effect of each study on the result and the level of heterogeneity. The results of the sensitivity analysis showed that no studies influenced the outcome and the level of heterogeneity. However, the pieces of advice were not associated with serious side effects. Conclusion According to the results, the success rate of this Tubingen brace was 88%. Moreover, the results must be interpreted with caution due to the small sample size and high heterogeneity. The effectiveness of this method in the long term is still debatable.