{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T20:12:52Z","timestamp":1757621572183,"version":"3.44.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Tampere University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>In the treatment of DDH, stable but dysplastic hips are safe to observe, and these children do not usually need abduction treatment. It has been reported, that also clinically unstable hips have good spontaneous recovery potential, but only a few studies have investigated the observation strategy in clinically mildly unstable (Barlow positive) hips. A conclusion on the safe treatment strategy for these children has not been made.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>All early diagnosed mildly unstable (Ortolani negative) hips treated in Tampere University Hospital in 1998\u20132018 were found, and data was retrospectively collected from the medical records. A total of 510 children were found. There were 222 children with Barlow-positive hips of which 45% were first observed, and 288 children with reported clinically mild hip instability but no reported Barlow-positivity of which 90% were first observed. All the analyses were done separately for these two groups of children.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Girls were more likely to need abduction treatment after observation in Barlow-positive and mildly unstable groups. There were no differences in the six-month alpha angle or treatment failure rates between early-treated and first-observed children in either of the study groups. Duration of the treatment was not increased in observed children in either of the study groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Observation for about a month in clinically mildly unstable hips with or without Barlow positive signs seems safe regarding the recovery of alpha angles, treatment duration and treatment failures. More research is needed for longer observation times.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12887-025-05940-x","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T16:34:00Z","timestamp":1754325240000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early abduction treatment versus observation in Barlow-positive and mildly unstable hips"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3374-8686","authenticated-orcid":false,"given":"Vilma","family":"Lankinen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Helminen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim","family":"Bakti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jarmo","family":"V\u00e4lipakka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannele","family":"Laivuori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Hyv\u00e4rinen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"issue":"20","key":"5940_CR1","first-page":"1717","volume":"97","author":"K Mulpuri","year":"2015","unstructured":"Mulpuri K, Song KM, Gross RH, Tebor GB, Otsuka NY, Lubicky JP, et al. The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age. The Journal of Bone and Joint Surgery-American Volume. 2015;97(20):1717\u20138.\u00a0http:\/\/journals.lww.com\/00004623-201510210-00011. [cited 18 Mar 2020].","journal-title":"The Journal of Bone and Joint Surgery-American Volume"},{"issue":"8","key":"5940_CR2","doi-asserted-by":"publisher","first-page":"359","DOI":"10.5694\/mja18.00154","volume":"208","author":"EK Schaeffer","year":"2018","unstructured":"Schaeffer EK, Mulpuri K. Developmental dysplasia of the hip: addressing evidence gaps with a multicentre prospective international study. Med J Aust. 2018;208(8):359\u201364.\u00a0https:\/\/pubmed.ncbi.nlm.nih.gov\/29716513\/. [cited 3 Feb 2022].","journal-title":"Med J Aust."},{"issue":"9","key":"5940_CR3","doi-asserted-by":"publisher","first-page":"e057906","DOI":"10.1136\/bmjopen-2021-057906","volume":"12","author":"EMB Paulussen","year":"2022","unstructured":"Paulussen EMB, Mulder FECM, Mathijssen NMC, Witlox MA. Active monitoring versus immediate abduction as treatment of stable developmental dysplasia of the hip: a systematic review of the literature. BMJ Open. 2022;12(9):e057906.\u00a0https:\/\/pubmed.ncbi.nlm.nih.gov\/36123097\/. [cited 21 Oct 2022].","journal-title":"BMJ Open"},{"key":"5940_CR4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0357","author":"K Rosendahl","year":"2010","unstructured":"Rosendahl K, Dezateux C, Fosse KR, Aase H, Aukland SM, Reigstad H, et al. Immediate treatment versus sonographic surveillance for mild hip dysplasia in newborns. Pediatrics. 2010. https:\/\/doi.org\/10.1542\/peds.2009-0357.","journal-title":"Pediatrics"},{"issue":"5","key":"5940_CR5","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.jor.2019.03.012","volume":"16","author":"KA Cook","year":"2019","unstructured":"Cook KA, Schmitt M, Ingram M, Larson JE, Burgess J, Janicki JA. Pavlik Harness initiation on Barlow positive hips: can we wait? J Orthop. 2019;16(5):378\u201381.","journal-title":"J Orthop"},{"issue":"2","key":"5940_CR6","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1302\/0301-620X.44B2.292","volume":"44","author":"TG Barlow","year":"1962","unstructured":"Barlow TG. Early diagnosis and treatment of congenital dislocation of, the hip. J Bone Joint Surg Br. 1962;44(2):292\u2013301. https:\/\/doi.org\/10.1302\/0301-620X.44B2.292.","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"5940_CR7","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1007\/s00247-013-2838-3","volume":"44","author":"LB Laborie","year":"2014","unstructured":"Laborie LB, Markestad TJ, Davidsen H, Brur\u00e5s KR, Aukland SM, Bj\u00f8rlykke JA, et al. Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991\u20132006. Pediatr Radiol. 2014;44(4):410\u201324.","journal-title":"Pediatr Radiol"},{"issue":"7","key":"5940_CR8","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1097\/BPO.0000000000000930","volume":"39","author":"JE Larson","year":"2019","unstructured":"Larson JE, Patel AR, Weatherford B, Janicki JA. Timing of Pavlik harness initiation: can we wait?? 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BMC Pediatr. 2023;23(1):148 https:\/\/pubmed-ncbi-nlm-nih-gov.libproxy.tuni.fi\/37004001\/. [cited 8 Apr 2023].","journal-title":"BMC Pediatr"},{"issue":"1","key":"5940_CR13","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1186\/s13018-022-03432-7","volume":"17","author":"K Bakti","year":"2022","unstructured":"Bakti K, Lankinen V, Helminen M, V\u00e4lipakka J, Laivuori H, Hyv\u00e4rinen A. Clinical and sonographic improvement of developmental dysplasia of the hip: analysis of 948 patients. J Orthop Surg Res. 2022;17(1):538 https:\/\/pubmed.ncbi.nlm.nih.gov\/36510263\/. [cited 15 Dec 2022].","journal-title":"J Orthop Surg Res"},{"key":"5940_CR14","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2023.2290694","author":"V Lankinen","year":"2023","unstructured":"Lankinen V, Vuorinen RL, Helminen M, Bakti K, V\u00e4lipakka J, Laivuori H, et al. Costs of abduction treatment in developmental dysplasia of the hip. Analysis of 900 patients. Ann Med. 2023. https:\/\/doi.org\/10.1080\/07853890.2023.2290694.","journal-title":"Ann Med"},{"issue":"1","key":"5940_CR15","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3390\/children11010097","volume":"11","author":"W Krysta","year":"2024","unstructured":"Krysta W, Dudek P, Pulik \u0141, \u0141\u0119gosz P. Screening of Developmental Dysplasia of the Hip in Europe: A Systematic Review. Children. 2024;11(1):97. Available from:\u00a0https:\/\/www.mdpi.com\/2227-9067\/11\/1\/97\/htm. [cited 5 Jun 2024].","journal-title":"Children"},{"issue":"8","key":"5940_CR16","doi-asserted-by":"publisher","first-page":"e2227638","DOI":"10.1001\/jamanetworkopen.2022.27638","volume":"5","author":"I Kuitunen","year":"2022","unstructured":"Kuitunen I, Uimonen MM, Haapanen M, Sund R, Helenius I, Ponkilainen VT. Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy: A Systematic Review and Meta-analysis. 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[cited 4 Oct 2021].","journal-title":"Int Orthop"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-025-05940-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12887-025-05940-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-025-05940-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T13:52:47Z","timestamp":1757339567000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-025-05940-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5940"],"URL":"https:\/\/doi.org\/10.1186\/s12887-025-05940-x","relation":{},"ISSN":["1471-2431"],"issn-type":[{"type":"electronic","value":"1471-2431"}],"subject":[],"published":{"date-parts":[[2025,8,4]]},"assertion":[{"value":"9 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was carried out according to Finnish national and European Union legislation and guidelines. The Regional Ethics Committee of the Expert Responsibility area of Tampere University Hospital approved the study. The need for patients\u2019 written consent was deemed unnecessary by the Regional Ethics Committee of the Expert Responsibility area of Tampere University Hospital as we did not contact the families to conduct this retrospective study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"596"}}